Health care, immigrants, and minorities: lessons from the affordable care act in the U.S.

Joseph, Tiffany D.; Marrow, Helen B.

doi:10.1080/1369183x.2017.1323446

Cited by 41 publications

(22 citation statements)

References 50 publications

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“…The BRFSS lack information on respondents' type of health insurance, place of birth, length of residence in the United States, citizenship status, and primary language spoken. Recent research has highlighted the diversity within the Hispanic population in this country and the differential impacts of the ACA on its various subpopulations (Alcala, Chen, Langellier, Roby, & Ortega, 2017;Joseph & Marrow, 2017;Sanchez, Vargas, Juarez, Gomez-Aguinaga, & Pedraza, 2017). Our findings expose the need for further research on how insurance coverage gains interact with access to care among Black and Hispanic adults.…”

Section: Discussionmentioning

confidence: 79%

The Effect of the Affordable Care Act Medicaid Expansion on Disparities in Access to Care and Health Status

Lee

Porell

2018

Med Care Res Rev

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Before the Affordable Care Act Medicaid expansion, nonelderly childless adults were not generally eligible for Medicaid regardless of their income, and Hispanics had much higher uninsured rates than other racial/ethnic subgroups. We estimated difference-in-differences models on Behavioral Risk Factor Surveillance data (2011-2016) to estimate the impacts of Medicaid expansion on racial/ethnic disparities in insurance coverage, access to care, and health status in this vulnerable subpopulation. Uninsured rates among all poor childless adults declined by roughly 9 percentage points more in states that expanded Medicaid. While expansion also had favorable impacts on most access and health outcomes among Whites in expansion states, there were relatively few such impacts among Blacks and Hispanics. Through 2016, Affordable Care Act Medicaid expansion was more effective in improving access and health outcomes among White low-income childless adults than mitigating racial/ethnic disparities.

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Section: Discussionmentioning

confidence: 79%

The Effect of the Affordable Care Act Medicaid Expansion on Disparities in Access to Care and Health Status

Lee

Porell

2018

Med Care Res Rev

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“…28 Generally, experts agree that the ACA also cemented certain inequities for noncitizens needing health care. 29,30 Even lawful noncitizens have historically been more vulnerable to being uninsured given that federal law bars receipt of federal benefits for the first 5 years of residence (although CHIPRA has allowed states to extend benefits to children and youth with legal status since 2009 and 33 have done so as of 2019), 5 and individuals lacking legal status are disallowed from receiving Medicaid, CHIP, or any premium assistance for private insurance.…”

Section: Health Coverage Disparities Among Adultsmentioning

confidence: 99%

“…Among immigrants, the coverage gap between adult citizens and noncitizen immigrants was practically eliminated, although a more recent study found that the uninsurance rate among adult noncitizen immigrants remained persistently high in states that did not expand Medicaid . Generally, experts agree that the ACA also cemented certain inequities for noncitizens needing health care . Even lawful noncitizens have historically been more vulnerable to being uninsured given that federal law bars receipt of federal benefits for the first 5 years of residence (although CHIPRA has allowed states to extend benefits to children and youth with legal status since 2009 and 33 have done so as of 2019), and individuals lacking legal status are disallowed from receiving Medicaid, CHIP, or any premium assistance for private insurance.…”

Section: Introductionmentioning

confidence: 99%

Effects of citizenship status, Latino ethnicity, and household language on health insurance coverage for U.S. adolescents, 2007‐2016

Knipper

Rivers²,

Goodman

2019

Health Services Research

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Objective/Study Question To examine changes in uninsurance rates among U.S. adolescents ages 12‐17 and assess whether trends over time differed by citizenship status, Latino ethnicity, and household language. Data Sources/Study Setting 2007‐2016 National Health Insurance Survey (NHIS). Study Design Multivariable logistic regression and postestimation marginal effects were used to assess changes in the current uninsured rate. Logistic regression models were used to determine significant trends over time for each demographic group and compare them to trends in the broader adolescent population. Marginal effects were employed to calculate adjusted outcome probabilities for each year. Principal Findings Across all 12‐ to 17‐year‐olds, the unadjusted uninsured rate dropped significantly between 2007 and 2016, from 10.2 percent to 6.0 percent. For noncitizen youth, the probability of being uninsured increased from 26.6 percent in 2007 to 28.4 percent in 2016, after controlling for covariates. Latino youth and those in Spanish‐speaking households saw declines in their adjusted uninsurance rate that was proportional to non‐Latino and English‐speaking youth. Conclusions Most adolescents saw significant improvements in health insurance coverage between 2007 and 2016; however, disparities remain among Spanish‐speaking and Latino adolescents and no improvements were seen among noncitizen youth. This suggests a need for equity‐focused eligibility, outreach, and enrollment policies that expand insurance options for these populations.

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“…The Northeastern states have higher relative lung cancer survival, better health rankings, lower health uninsured rate, and higher health spending per capita compared to the Southern states. This phenomenon can be explained by the similar characteristics among adjacent states, which include the demographics [percentage of total African American population by region according to the 2010 Census: Northwest (17%), Midwest (18.1%), South (55.0%), and West (9.8%)], numbers of physicians per capita, socioeconomic conditions, the availability of medical services, incomes of residents, and the levels of benefits provided by public and private health programs (22)(23)(24)(25)(26)(27). Affordability and access to state-of-the art cancer care are important factors for geographic differences of cancer survival.…”

Section: Discussionmentioning

confidence: 99%

State-Level Disparity in Lung Cancer Survival in the United States

et al. 2020

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The cancer mortality-to-incidence ratio (MIR) can serve as a population-based indicator for cancer care outcomes. In the US, evaluation of lung cancer survival by individual states has not been evaluated. Objective: To assess the association between lung cancer survival by using MIRs and state-level health disparities in the United States. Methods: We calculated 5-year lung cancer MIR averages from 2011 to 2015 using the United States Cancer Statistics (USCS) data. America's Health Rankings (AHR) is a platform using weighted measures in five different categories to calculate annual state health rankings. Five-year averages from 2011 to 2015 of the health uninsured rate and 4-year averages from 2011 to 2014 of health spending per capita were obtained from the U.S. Census Bureau and Centers for Medicare & Medicaid Services. Linear regression analyses were performed to determine the associations between cancer survival value (CSV) = (1-MIR) × 100% and state health variables. Results: During the study period, the 5-year averages of age-adjusted incidence, mortality rates, and CSVs were 60.3 ± 2.1 per 100,000 population, 43.4 ± 2.1 per 100,000, and 27.9 ± 3.9%, respectively. Among the 50 states, Connecticut had the highest CSV (38.6 ± 1.7%) whereas Nevada had the lowest CSV (18.7 ± 6.5%). Hawaii had the highest health ranking and Mississippi had the lowest ranking in 2016. States with better health rankings, lower health uninsured rates, and higher health spending were significantly associated with higher CSVs (R 2 = 0.418, P < 0.001; R 2 = 0.352, P < 0.001; R 2 = 0.142, P = 0.007, respectively). Conclusions: There are significant differences in lung cancer survival within the United States. Lung cancer survival by using CSV was strongly associated with state health disparities, and it can be an applicable measure to evaluate the state-level health disparities in the United States.

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Health care, immigrants, and minorities: lessons from the affordable care act in the U.S.

Cited by 41 publications

References 50 publications

The Effect of the Affordable Care Act Medicaid Expansion on Disparities in Access to Care and Health Status

The Effect of the Affordable Care Act Medicaid Expansion on Disparities in Access to Care and Health Status

Effects of citizenship status, Latino ethnicity, and household language on health insurance coverage for U.S. adolescents, 2007‐2016

State-Level Disparity in Lung Cancer Survival in the United States

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