The 2010 Patient Protection & Affordable Care Act (ACA) significantly expanded access to private and public health insurance for low-income individuals through income-based subsidies and income-based eligibility expansions, respectively. In this paper, we use the universe of hospitals from 2009 to 2015 to characterize how these expansions affected the financing of hospital visits, along with price, utilization, and potential spillovers in the quality of care. The insurance coverage expansions generated a shift in the composition of payers and a modest increase in the utilization of hospital outpatient services. While concerns have been raised that these shifts in utilization could cause negative spillovers to the already insured population (e.g., Medicare enrollees), we find no significant change in the quality of care experienced by those already insured. The primary result of both federally funded insurance expansions was to increase the profits generated and prices charged by the hospitals providing such services.

2010 年《患者保护与平价医疗法案》(ACA) 分别通过基于收入的补贴和基于收入的资格扩展，显着扩大了低收入个人获得私人和公共医疗保险的机会。在本文中，我们使用 2009 年至 2015 年的医院范围来描述这些扩张如何影响医院就诊的融资，以及价格、利用率和护理质量的潜在溢出效应。保险覆盖范围的扩大导致支付者构成发生转变，医院门诊服务的利用率略有增加。虽然有人担心这些利用的转变可能会对已经投保的人群（例如医疗保险参保者）造成负面影响，我们发现已经投保的人所体验的护理质量没有显着变化。联邦政府资助的保险扩张的主要结果是增加提供此类服务的医院产生的利润和收费。