Fitch Ratings, a credit rating agency, reported states that expanded health insurance access under the Affordable Care Act have seen substantially faster growth in healthcare jobs than those that did not since the first expansions began last January. The gains in healthcare jobs suggest ACA expansion is generally positive for that sector’s employment profile, according to Fitch.

Fitch’s analysis of data from the US Bureau of Labor Statistics found healthcare and social assistance jobs grew on average 2.4% year over year between December 2013 and December 2014 for 24 states that implemented ACA expansion on Jan. 1, 2014. This is faster than the 1.8% increase for 24 states that did not expand the ACA. Data for Alaska, a non-expansion state, and New Mexico, an expansion state, was not available.

“However, the ACA is very broad legislation with a wide range of effects on state economies and budgets,” Fitch stated. “We believe this healthcare job growth would need to continue into the longer term to be directly attributable to the ACA.”

Fitch Ratings says it could support a broader economic and tax base for state budgets and improve nonprofit hospital finances in states with expanded ACA coverage. However, states that expanded ACA are also more exposed to potential federal deficit reduction efforts than non-expanding states.

“The impact on nonprofit hospitals is more direct as it raises a hospital’s number of patients with coverage,” Fitch stated. “We believe revenue growth at hospitals in states that did not expand will generally be constrained by a larger number of uninsured patients amid modest volume growth and increasing bad debt related to higher patient co-pays and deductibles.”