Access-To-Care Differences Between Mexican-Heritage And Other Latinos In California After The Affordable Care Act

Abstract

We examined changes in health insurance coverage and access to and use of health care among adult (ages 18-64) Latinos in the US before (2007-13) and after (2014-16) implementation of the main provisions of the Affordable Care Act. Data from the California Health Interview Survey were used to compare respondents in the two periods. We used multivariable and decomposition regression analyses to investigate the role of documentation status in access disparities between Mexicans and other Latinos in California. Our findings show that after the implementation of these provisions in California, insurance coverage increased for US- and foreign-born Latinos, including undocumented Latinos. Our decomposition analyses show that after implementation, disparities between Mexicans and other Latinos declined with respect to having coverage and a usual source of care. Without the implementation of these provisions in 2014, these disparities would have been 5.76 percent and 0.31 percent larger, respectively. In contrast, legal documentation status was positively associated with disparities between Mexicans and other Latinos in having coverage and physician visits. If Mexican Latinos had had the same share of undocumented immigrants as other Latinos, disparities in health insurance coverage would have declined by 24.17 percent.

Renal Cell Carcinoma Health Disparities in Stage and Mortality among American Indians/Alaska Natives and Hispanic Americans: Comparison of National Cancer Database and Arizona Cancer Registry Data

“…HA is an aggregate term for heterogeneous subgroups from various origins with different cultures, health behaviors, and genetic admixtures. These subgroups also have historically different healthcare access across the U.S. Mexican Americans and HAs from Central and South America are less likely to utilize healthcare services [ 13 ]. HAs are more likely to be uninsured in the U.S. both pre- and post-implementation of the Affordable Care Act [ 14 , 31 ].…”

“…Kidney cancer trends and the patterns of disparities in AIs/ANs and HAs at national- and regional-levels are not well studied. AIs/ANs and HAs have socioeconomic disadvantages as well as structural, geographic, and individual barriers to healthcare [ 11 , 12 , 13 , 14 ], but underlying causes of the disparities have not been understood in these populations. Previous kidney cancer studies had limited geographic scope in their analyses or focused primarily on epidemiological data without an in-depth analysis of the complex dimensions of socioeconomic and geographic factors that may be driving kidney cancer disparities [ 5 , 6 , 15 , 16 , 17 ].…”

Challenges for Adult Undocumented Immigrants in Accessing Primary Care: A Qualitative Study of Health Care Workers in Los Angeles County

“…2,3,7 Lack of coverage has led to harmful delays in care, increased acute care utilization, and poor health outcomes. [4][5][6][8][9][10][11][12][13][14][15][16][17] In addition, recent changes and even proposed changes to immigration policies and practices have engendered fear within immigrant communities, resulting in further negative health and social impacts. [18][19][20][21][22][23][24] These policies, in addition to other challenges (e.g., language, discrimination, and stigma), result in a formidable health care environment for undocumented immigrants.…”

Comparison of Use of Health Care Services and Spending for Unauthorized Immigrants vs Authorized Immigrants or US Citizens Using a Machine Learning Model

“…20,21 However, unauthorized immigrants experience substantial legal and economic barriers to accessing health care in the US. 22 In addition to risks of arrest and deportation, [22][23][24][25] Although implementation of the Patient Protection and Affordable Care Act may have helped decrease the uninsured population, these benefits were smaller for noncitizen immigrants than for naturalized citizens or US-born individuals. 26 However, the epidemiological paradox does not necessarily mean that our finding of lower utilization of health care for immigrants than US-born individuals is desirable.…”