Even as value-based care solutions are becoming popular, some people don’t have access to necessary healthcare facilities. Uninsured adults with incomes low enough to qualify for expanded Medicaid eligibility as per the Affordable Care Act- but not living in an expansion state- were more likely to not get access to necessary healthcare services, according to a new study from the Government Accountability Office (GAO).

Based on the data from the 2016 National Health Interview Survey, the nonpartisan GAO found that 20% of low-income adults in non-expansion states reported that they could not afford the necessary medical care as compared with 9.4% of low-income adults in expansion states.

Of the uninsured, low-income individuals qualifying for Medicaid expansion, but not living in an expansion state, the majority were male and more than half of them were employed. The study revealed that most of them had income less than 100% of the federal poverty level.

An estimated 5.6 million people qualified for expanded Medicaid eligibility with about 3.7 million of them living in non-expansion states. In total, Medicaid covered 72.2 million individuals in the U.S. at a cost of $575.9 billion that year.