OBJECTIVES: People in the USA could not access required healthcare in a timely manner becasue lack of affordability. The Patient Protection and Affordable Care Act (PPACA) was implemented in the year 2010 to increase access to medical care by improving affordability. The objective of this study was to evaluate the impact of affordability on accessibility of medical care in the USA after implementation of PPACA.   METHODS: This cross-sectional study analyzed data from 2013-2014 National Health Interview Survey (NHIS). The study included adults who experienced affordability problems. A person was classified as having difficulty in accessing medical care if the person was unable to receive needed medical care or experienced delay in obtaining it or encountered both problems. Logistic regression model, after adjusting for socio-demographic characteristics was used to assess impact of affordability on accessibility. RESULTS: A total of 45,865 individuals were included in the analysis. Majority was non-Hispanic white (56.41%), females (54%), had some insurance (74.93%), married (51.69%) and attended some college (50.79%). A total of 27,242 (59.40%) had problems paying or were unable to pay any medical care, 8,196 (17.87%) could not pay medical bills over time, and 10,833 (23.62%) respondents experienced difficulties to access because of worry about cost. Odds of difficulty to access was significantly higher (OR = 3.39, 95%CI = 3.19, 3.61) for those with affordability issues compared to those without any problem. Ability to pay off bill over time decreased the difficulty to access (OR = 0.90, 95% CI = 0.85, 0.96). Being uninsured, female, unmarried, having poor health status and low income could significantly decrease the odds of access. CONCLUSIONS: Lack of affordability adversely impacted accessibility of medical care even after implementation of PPACA. Increase in affordability through various policy measures is required to improve accessibility to medical care among vulnerable groups.