Estimates of medical bills under the Patient Protection and Affordable Care Act found most household budgets can afford premiums and other healthcare expenses after paying bills for food, child care, transportation and other necessities, a newly released report shows.

About 8.5% to 9% of households living closest to the poverty line could not afford basic necessities and typical medical bills proposed by the 2010 health reform law, according to a report by the Commonwealth Fund.

Under the law, individuals are required to have insurance in 2014, with a few exceptions. The law limits household out-of-pocket costs and subsidizes plans sold through insurance exchanges to low-income individuals. Fewer households in high cost-of-living states could afford healthcare expenses, according to the study.

The report included projections of spending on necessities, premiums and out-of-pocket costs for households between the federal poverty line and 500% of the threshold. Those insured by safety net or exchange plans were included in the projections.

As income increased, the projection generally found fewer households unable to afford typical health expenses. However, high out-of-pocket costs left significantly more households unable to afford medical bills. Roughly one out of four households between 200% and 300% of federal poverty were unable to afford necessities and medical bills when faced with high out-of-pocket costs, the report said.