evidence: A large body of research shows that Medicaid beneficiaries have substantially better access to care than people who are uninsured (who are also primarily low-income) and are less likely to postpone or go without needed care due to cost. Key measures of access to care and satisfaction with care among Medicaid enrollees are comparable to rates for people with private insurance (Figure 7). Given that Medicaid enrollees have low incomes, federal rules generally have protections to limit out of pocket costs that can help improve access. Longstanding research shows that Medicaid eligibility during childhood is associated with positive effects on health and effects beyond health such as improved long-run educational attainment. Early and updated research findings show that state Medicaid expansions to adults are associated with increased access to care, improved self-reported health status, reduced mortality among adults, and increases in economic security.