Low-income adults in states that expanded Medicaid under the Affordable Care Act were more likely to visit a doctor or hospital and be initially diagnosed with diabetes and high cholesterol, according to a recent study.

The research, published in the American College of Physicians’ Annals of Internal Medicine, also showed that individuals in the states with expanded care, despite increased insurance coverage and utilization of care, did not report improvement in self-assessment of their current health. Authors Laura Wherry, PhD, of UCLA, and Sarah Miller, PhD, of the University of Michigan, believed increased care and information about their health might be partially responsible for negative opinions.

The study compared health outcomes for low-income patients before and after the expansion in Medicaid in states that both did and did not expand its programs. By the second half of 2014, when 26 states and Washington, D.C., had expanded their Medicaid programs, Medicaid coverage grew by 10.5 percent compared to non-expansion states.

Medicaid expansions led to increased physician visits (by 6.6 percent) and overnight hospital stays (by 2.4 percent), as well as increased rates of diagnosis for diabetes (5.2 percent) and high cholesterol (5.7 percent). Since 2014, five states have expanded Medicaid, and the total number of Americans enrolled in the program has topped 71 million, according to CMS. More than 14 million users have joined since the expansion of the Medicaid program in 2014 using funds from the ACA.