Wisk LE, et al. - This cohort study draws on data from the 2000-2017 Medical Expenditure Panel Survey, a nationally representative, population-based survey to analyze changes in a healthcare-related financial burden for US families with children before and after the Affordable Care Act (ACA) was implemented based on income eligibility for ACA policies. According to findings, after the ACA was implemented, low- and middle-income families with children who were eligible for ACA Medicaid expansions and Marketplace subsidies reported greater decreases in healthcare-related financial burden relative to higher-income families. Despite ACA policies, however, many low- and middle-income families with children seem to continue to experience considerable financial burden from premiums and out-of-pocket costs.