Sept. 24 (UPI) — Researchers have linked a nearly 20% decline in “catastrophic” healthcare expenditures during the last decade to changes made as a result of the Affordable Care Act, according to an analysis published Thursday by JAMA Network Open.

An estimated 11.2 million Americans experienced “catastrophic” healthcare expenditures in 2017, down from 13.6 million in 2010, researchers reported. The ACA was signed into law in 2010 and fully in effect by 2014.

The researchers defined catastrophic health expenditures as calendar year out-of-pocket costs plus premium spending that exceeds 40% of post-subsistence income — or income minus typical food and housing expenditures.

While low-income households saw a 2.3% reduction in risk for catastrophic health expenditures between 2010 and 2017, the risk still was more than twice that of those with higher incomes, the researchers said.

“These findings help to explain why so many U.S. residents, including those with insurance, continue