read this text and porivde an outline in bulelt format in maximum 150 words: Impact of the Affordable Care Act on Medicaid Coverage and Cost
Several academic research demonstrated the importance of the Affordable Care Act when it comes to expanding eligibility for the Medicaid program. By raising the eligibility threshold to 138% of the federal poverty level, the ACA aimed to increase access to healthcare for low-income individuals, particularly those previously excluded due to stringent eligibility criteria (Isola & Reddivari, 2024). This expansion allowed millions of previously uninsured adults, including those without dependents, to qualify for Medicaid, thereby broadening the program's coverage and attempting to achieve universal health insurance. Critics, however, expressed concerns about potential constitutional issues, arguing that the federal government might be overstepping its authority and infringing on states' rights (Isola & Reddivari, 2024). While these concerns persisted, the primary role of the expansion was to reduce the high rate of uninsured people in the population, which was expected to lead to better health outcomes among the vulnerable population. 
Based on academic studies in this field, empirical evidence was retrieved that confirmed the fact that the Medicaid expansion under the ACA was an effective manner to reduce the uninsured rate. This was even more evident in case of parents with a low income who were already eligible prior to the enactment of the law. (McMorrow & Kenney, 2021). The expansion led to a 12.6 percentage point reduction in uninsurance among this group, marking a 40% decline from the baseline rate of 30.5% uninsurance (McMorrow & Kenney, 2021). These coverage gains intensified over time, with a 17 percentage point drop in uninsurance two to three years following the expansion, indicating that the ACA's policies had a sustained positive spillover effect on previously eligible populations. While some evidence pointed to increased delays in care due to transportation issues and difficulties in finding a doctor in later years, these findings were not consistent across all analyses and may reflect growing awareness of healthcare needs rather than systemic access problems (McMorrow & Kenney, 2021).  It can be stated that the expansion mentioned did indeed benefit the parents with a low income by improving coverage but without the potential substantial access barriers. 
Another element that is worth mentioning is the fact that this expansion of Medicaid also had a positive impact in terms of both access to primary care together with healthcare costs. In states that expanded Medicaid, there was a slight decrease in preventable hospitalizations over time, suggesting improved access to primary care services that could address conditions before they necessitate hospitalization (Brown et al., 2021). Although this decrease was not statistically significant, the trend implies that expanding Medicaid eligibility might reduce unnecessary healthcare expenditures associated with preventable conditions, aligning with the ACA's goal of decreasing unnecessary costs in healthcare (Brown et al., 2021).However, disparities persisted due to factors like Medicaid reimbursement rates and physician availability. It is worth noting that while this expansion did have favorable implications for the cost, they tended to differ due to implementation and local factors.