As the future of the ACA is debated, questions have been raised about the value of the law’s health insurance coverage expansions. Drawing on data from the Commonwealth Fund’s just-released Scorecard on State Health System Performance, 2017, Susan Hayes, Douglas McCarthy, David Radley, and Sara Collins explore whether the ACA improved access to care. The authors examine the experience of Kentucky, a state that expanded Medicaid eligibility and ran its own health insurance marketplace through 2016.