Access to health care declined for adults under 65 in nearly every state over the past decade, especially among those without insurance, according to a new study by the Urban Institute. Between 2000 and 2010, the share of U.S. adults under 65 reporting unmet medical needs rose in 42 states; the share of adults reporting a routine check-up fell in 37 states; and the share of adults reporting a routine dental visit declined in 29 states. Only West Virginia and the District of Columbia did not experience a decline in at least one of the three measures over the decade. "This analysis suggests that the potential benefits of the coverage expansion in the Affordable Care Act are large and exist in every state," the authors said. The findings are based on data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.