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The impact of the affordable care Act (ACA) on favorable risk selection and Beneficiaries' health status in Medicare advantage: a preliminary assessment.

BMC Health Serv Res · 2016 · PMC4990876 · PMID 27539191

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a decreasing trendno p-value reported
Unadjusted trends of health status measures at baseline showed that between 2007 and 2009, beneficiaries showed a decreasing trend in SRH that was reversed in 2010.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.