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Expanded states showed a decrease in uncompensated care in comparison to non-expanded states. However, although a decrease in uncompensated care is apparent, hospitals in expanded states did not decrease their costs, which raises further questions about whether Medicaid expansion had a direct effect on hospital service costs. This study indicates that the Medicaid expansion increased access to Medicaid insurance. Expanded states showed a decrease in uncompensated care in comparison to non-expanded states. However, although a decrease i