Low-income adults in two states experienced significant improvements in care after Medicaid services were expanded as part of the Affordable Care Act, according to a recent analysis.

Researchers found that Medicaid expansions in Arkansas and Kentucky resulted in better primary care access and lower out-of-pocket costs for low-income adults. This is in comparison to similar patients in Texas, where coverage has remained the same. Improvements in Arkansas and Kentucky also were made in care for chronic conditions within the states where the expansions occurred, according to the study.

The results were compiled from the survey responses of nearly 9,000 low-income adults in the three states. The surveys were conducted for two years, ending in December 2015.

“It certainly does not seem that [the ACA is] an empty benefit,” Dr. Benjamin Sommers, the study’s lead author said.  “This insurance expansion, even in those areas, is helping people get the care that they need.”

Uninsured rates in Arkansas dropped 28% in the two years since the expansion took place, while Kentucky’s rates fell 31%. Texas saw a less than a 5% decrease during the same timeframe.

The study was published online Aug. 8 in JAMA Internal Medicine.