“Canaries in the mine...” the impact of Affordable Care Act implementation on people with disabilities: Evidence from interviews with disability advocates

Our results depict a complex interplay between the ACA, state efforts and community outreach that influenced people with disabilities' experience. While coverage gains were generally positive, challenges emerged in plan selection and accessing care following enrollment. Attending to contextual factors like state climate and navigator experience as part of ACA implementation may determine health care access, and, ultimately, the health status, of people with disabilities and other population groups.