Medicaid expansion under the Affordable Care Act was designed to provide broader basic medical coverage for Americans. Unfortunately, it’s not helping them meet US healthcare’s still-rising costs.

According to a new study released by the non-profit Kaiser Family Foundation, only 11% of America’s non-elderly population remains uncovered — the lowest such percentage in history. But coverage expansion has also been paired with significant cost-shifting onto healthcare consumers.

That, exacerbated by rising medical care, supply and pharmaceutical costs that far outpace inflation, is preventing even many covered individuals from accessing care.

More than 1 in 4 US citizens report that they are either currently uninsured, or that they have in the past year delayed or skipped medical care when they’ve needed it due to its out-of-pocket costs, wrote Kaiser’s president and CEO Drew Altman.

“More striking: nearly half of all people in fair or poor health — 46.4% — are uninsured or have affordability problems despite having coverage,” he observed.

Read Altman’s entire op-ed here, in Axios.