Access to health insurance coverage has changed significantly following changes in public and private insurance due to the Patient Protection and Affordable Care Act (PPACA). From 2013-2016, the PPACA led to an overall increase in coverage rates of nearly 13 and 11 percentage points in nonmetropolitan and metropolitan areas, respectively. Nearly 10 percentage points of the overall coverage gain in the nonmetropolitan areas was due to Medicaid expansion, while other PPACA provisions increased coverage by about 3 percentage points. Among individuals below 138% of the federal poverty level living in nonmetropolitan areas in 2016, Medicaid expansion increased the likelihood of having a routine visit in the past year by 6 percentage points (relative to 2013).