The Affordable Care Act was designed to help people like David Elson. He had a box full of unpaid medical bills, a result of uncontrolled diabetes and all the health complications that came with it. He badly needed health insurance, but as a self-employed alarm installer, he could not afford it — especially since insurers could charge chronically ill people much more before the new law took effect.

The New York Times started following Mr. Elson in Louisville, Ky., in the months before the law’s new insurance marketplaces opened. Kentucky was the only Southern state to both expand Medicaid for low-income residents and open its own marketplace where others could buy private coverage, often with financial assistance. Would David Elson finally get health insurance, and would his life change as a result?

This Times Documentary grew out of a series of articles, “Remaking Medicine,” in which we traced how the health care law affected lives in one city.