More than 8 years ago, President Obama signed the Patient Protection and Affordable Care Act into law. It is arguably one of the most important pieces of legislation of his administration.¹ As a result of optional Medicaid expansion under the Affordable Care Act, millions of Americans in 32 participating states and the District of Columbia have gained access to affordable and high-quality health insurance.² However, the remaining states have chosen not to participate in the Medicaid expansion, creating an organic opportunity to appropriately study outcomes between expansion states and nonexpansion states. Such an opportunity can prove fruitful for studying trauma in the United States, which still remains the leading cause of death and disability among individuals younger than 44 years.³

八多年前，奥巴马总统签署了《患者保护和负担得起的医疗法案》，成为法律。可以说，这是他执政期间最重要的立法之一。¹由于根据《平价医疗法案》（Affordable Care Act）可选地扩大了医疗补助计划，在32个参与州和哥伦比亚特区的数百万美国人获得了负担得起的高质量医疗保险。^2个但是，其余的州选择不参加医疗补助计划的扩张，这为有机地研究扩张状态和非扩张状态之间的结果提供了有机的机会。这样的机会可以证明在美国研究创伤方面富有成果，在美国，创伤仍然仍然是44岁以下儿童死亡和残疾的主要原因。³