Affordable Care Act Expansion and Orthopaedic Surgery: Over a Decade of Impact.

» Affordable Care Act Medicaid expansion increased orthopaedic surgery access and utilization among Medicaid patients, including for racial and ethnic minorities.» Despite improved coverage, Medicaid patients continue to face significant real-world barriers to orthopaedic care, including lower appointment success and longer wait times compared with privately insured patients.» Evidence on cost and quality impacts remains limited, with early signals of increased reimbursements, higher charges, and some quality improvements postexpansion.