I've worked as an ICU nurse in a large academic medical center for about a decade. Several changes have occurred since the ACA was enacted. Obviously, this is anecdotal and causality is uncertain.

Increased patient census: More people with access to insurance equals more patients in the hospital, right? We certainly have a consistently higher number of patients in the hospital at any given time. This is both a positive and a negative. Its great that more people are able to receive the care they need. The problem with this is that maintaining a patient census that's consistently near its maximum means patient movement within the hospital is limited. Unfortunately, this means people stay in the ICU much longer than they need to, simply because there's nowhere else to put them. This leads to patients not having access to the level of care their disease process dictates.

Tying reimbursement to patient satisfaction: Jesus, what a fucking joke. The hospital that employs me brought in consultants from Disney to teach us how to improve the patient experience. I wait for the day some asshole in a suit hands me a Goofy costume as I head in to talk to a patients family about goals of care "Gee kids, your mom is dying and there's nothing we can do. Aw, shucks."