Intra‐Ethnic Coverage Disparities among Latinos and the Effects of Health Reform

Gonzales, Sergio; Sommers, Benjamin D.

doi:10.1111/1475-6773.12733

Cited by 21 publications

(11 citation statements)

References 19 publications

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“…6,11 Recent studies that used national data have found that health insurance coverage and access to care after the ACA differ significantly among Latino heritage groups. 3,5 Our study confirms these findings and shows that differences across the groups have narrowed after the implementation of the ACA in California.…”

Section: Discussionsupporting

confidence: 82%

“…These findings are consistent with the results of other studies and may suggest that health care use is mostly linked to medical need. 3,5 Need could also be a factor related to the lack of significant differences between US-born, documented, and undocumented Latinos in the odds of having had a physician visit. Interestingly, the decomposition analyses showed that observable characteristics accounted for a large proportion of disparities in having physician visits and a usual source of care between Mexicans and other Latinos.…”

Section: Discussionmentioning

confidence: 99%

“…9–11 Research that has investigated changes in access to care among Latinos after implementation of the main provisions of the ACA—such as the health insurance mandate, federal subsidies for health insurance, and elimination of restrictions on preexisting conditions— showed that the law has contributed to closing the coverage gap across different Latino heritage groups. 3,5 To our knowledge, though, no study has investigated the role of documentation status in explaining differences between Mexicans and other Latinos. The focus on Mexican Latinos is particularly salient since 33.7 million Latinos in the US are of Mexican heritage, and they are the largest group (64 percent) of US Latinos.…”

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confidence: 99%

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

et al. 2018

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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.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

et al. 2018

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“…). Heterogeneous effects within the Latino group were further evidenced by one study examining 2014 Medicaid expansion; the effect size on uninsured rate ranges from −0.0087 to −0.0839 within Latinos and was −0.0427 for whites (Gonzales and Sommers ). But our results contrast with findings that insurance disparities diminished in Oregon based on electronic health record data (Heintzman et al.…”

Section: Discussionmentioning

confidence: 97%

“…; Courtemanche et al. ; Gonzales and Sommers ; Wehby and Lyu ). These results may be due to the fact that minority groups typically have larger proportions of low‐income adults eligible for Medicaid under expansion.…”

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confidence: 97%

Racial/Ethnic Differential Effects of Medicaid Expansion on Health Care Access

Yue

Rasmussen

Ponce

2018

Health Services Research

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Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth

Brown

Moore

Felix

et al. 2019

JAMA

107

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IMPORTANCE Low birth weight and preterm birth are associated with adverse consequences including increased risk of infant mortality and chronic health conditions. Black infants are more likely than white infants to be born prematurely, which has been associated with disparities in infant mortality and other chronic conditions. OBJECTIVE To evaluate whether Medicaid expansion was associated with changes in rates of low birth weight and preterm birth outcomes, both overall and by race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS Using US population-based data from the National Center for Health Statistics Birth Data Files (2011-2016), difference-indifferences (DID) and difference-indifference in differences (DDD) models were estimated using multivariable linear probability regressions to compare birth outcomes among infants in Medicaid expansion states relative to non-Medicaid expansion states and changes in relative disparities among racial/ethnic minorities for singleton live births to women aged 19 years and older. EXPOSURES State Medicaid expansion status and racial/ethnic category. MAIN OUTCOMES AND MEASURES Preterm birth (<37 weeks' gestation), very preterm birth (<32 weeks' gestation), low birth weight (<2500 g), and very low birth weight (<1500 g). RESULTS The final sample of 15 631 174 births (white infants: 8 244 924, black infants: 2 201 658, and Hispanic infants: 3 944 665) came from the District of Columbia and 18 states that expanded Medicaid (n = 8 530 751) and 17 states that did not (n = 7 100 423). In the DID analyses, there were no significant changes in preterm birth in expansion relative to nonexpansion states (preexpansion to postexpansion period, 6.80% to 6.

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Intra‐Ethnic Coverage Disparities among Latinos and the Effects of Health Reform

Abstract: Latino subgroups show marked heterogeneity in baseline coverage rates and responses to the ACA.

Cited by 21 publications

References 19 publications

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

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

Racial/Ethnic Differential Effects of Medicaid Expansion on Health Care Access

Association of State Medicaid Expansion Status With Low Birth Weight and Preterm Birth

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