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In states that expanded Medicaid under the Affordable Care Act, low-income adults were more likely to see a doctor, stay overnight in a hospital and receive their first diagnoses of diabetes and high cholesterol, according to a study published Monday.

Yet researchers found no improvement in adults’ own assessments of their health, a conclusion echoed by similar studies, the authors wrote in the Annals of Internal Medicine.

Two factors might explain the lack of perceived improvement. People did not sign up for Medicaid as soon as it expanded in January 2014 so there was little time to better their health. Also, survey participants’ increased contact with health providers and fresh knowledge about their health might have negatively affected their opinions, the authors said.

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