When the Affordable Care Act passed, many people focused on the law's creation of marketplaces to help the uninsured buy coverage, often with the help of federal subsidies.

But the law also greatly expanded the number of people eligible for Medicaid, the state-run health insurance program for people with low incomes. States had the choice whether or not to go along with the expansion after the Supreme Court ruled that the law couldn't compel them to do it.

All told, 27 states and the District of Columbia have decided to make it easier for people to get Medicaid coverage, according to the Kaiser Family Foundation. Seven states are still thinking about it, and 16 states have decided against it, for now anyway.

In negotiations during the drafting of the law, hospitals agreed to cuts in federal payments for uncompensated care with the expectation that millions of people would become paying customers thanks to the Medicaid expansion.

It turns out that hospitals in states that took the Medicaid plunge have benefited, Kaiser Health News' Sarah Varney reports for the PBS NewsHour.

Seattle's Harborview Medical Center, a safety-net hospital owned by King County, has seen the percentage of uninsured patients drop from 14 percent to 4 percent since Washington state loosened Medicaid eligibility.

The lack of insurance coverage for so many people "cost us all," King County Executive Dow Constantine told Varney. "It cost us in absenteeism at work. It cost us in days missed at school. And it just plain cost us on our health care bills."

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