Purpose: Limited English proficiency adversely impacts people's ability to access health services. This study examines the association between English language proficiency and insurance access and use of a usual care provider after the implementation of the Affordable Care Act (ACA). Methods: Using cross-sectional data from the 2016 Medical Panel Expenditures Survey, we identified 24,099 adults (weighted n =240,035,048) and categorized them by self-reported English-language proficiency. We classified participants according to responses to: “How well do you speak English? Would you say… Very well; well; Not well; Not at all?” (having limited English proficiency: not well; not at all, English proficient: well; very well; and English only: not applicable) and “What language do you speak at home? Would you say… English, Spanish, Other.” Using these two recoded variables, we created a variable with five categories: (1) Spanish speaking, with limited English proficiency, (2) other language speaking, with limited English proficiency, (3) Spanish speaking, English proficient, (4) other language speaking, English proficient, and (5) English only. Health insurance and usual care provider were determined by self-report. Results: Among those <65 years, the percent covered by public insurance (Spanish: 21%, Other languages: 28%, English only 14%), who were uninsured (Spanish: 46%, Other languages: 17%, English only: 8%), and who lacked a usual care provider (Spanish: 45%, Other languages: 35%, English only: 26%) differed by English language proficiency. Among those ≥65 years, fewer people with limited English proficiency relative to English only were dually covered by Medicare and private insurance (Spanish: 12%, Other languages: 15%, English only: 59%), and a higher percent lacked a usual care provider (Spanish: 15%, Other languages: 11%, English only: 7%). Differences persisted with adjustment for covariates. Conclusion: Post the ACA, persons with limited English proficiency remain at a risk of being uninsured relative to those who only speak English.

Objectives: To evaluate the extent to which dental health care visits in the past year differed among older adults with and without edentulism. Material and Methods: We conducted a cross-sectional study using the 2017 Medical Expenditure Panel Survey among participants aged ≥50 years (n = 10,480, weighted = 112,116,641). Two self-reported outcome variables were used: loss of all teeth from upper and lower jaws (yes/no) and dental visit in the last 12 months (yes/no). Logistic models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).

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Objectives: This study sought to provide population-based estimates of complete tooth loss and recent dental visits among older adults in the United States by English language proficiency. Methods: We conducted a cross-sectional analysis of the 2017 Medical Expenditure Panel Survey among participants ⩾50 years of age (n = 10,452, weighted to represent 111,895,290 persons). Five categories of language proficiency were created based on self-reported English language ability and language spoken at home (Spanish, Other). Results: The prevalence of complete tooth loss was higher among those with limited English proficiency (Spanish speaking: 13.7%; Other languages: 16.9%) than those proficient in English (Spanish speaking: 5.0%; Other languages: 6.0%, English only: 12.0%). Complete tooth loss was less common among participants for whom Spanish was their primary language, with limited English proficiency relative to English only (adjusted odds ratio: 0.56; 95% confidence interval: 0.42–0.76). Among those without complete tooth loss, dental visits in the past year were less common among participants with primary language other than English as compared to those who only speak English. Conclusions: Complete tooth loss varied by English language proficiency among adults aged ⩾50 years in the United States. Suboptimal adherence to annual dental visits was common, more so in those with complete tooth loss, and varied by English language proficiency.