Should-Read: Medicaid expansion vs. non-expansion and household financial adversity:
Kenneth P. Brevoort, Daniel Grodzicki, and Martin Hackmann: Medicaid and Financial Health https://www.fdic.gov/news/conferences/consumersymposium/2016/documents/brevoort_presentation.pdf:
Plus state government nullification or non-nullification and insurer competition:
Hannah Recht: Health Insurance Marketplaces: Looking Forward to 2018: "Most of the 12 million people who got health insurance through Obamacare’s individual marketplaces will have the same number of companies to choose among next year as they did in 2017..." https://www.bloomberg.com/graphics/health-insurance-marketplaces-for-2018/:
Where state governments want to diminish the threat of medical bankruptcy, medical bankruptcy is diminished. Where state governments want individuals to see competition for their business from health insurers, individuals see competition for their business from health insurers.