“…Black and White enrollees initiated care at similar rates (ie, there were small racial differences in the likelihood of using any primary care), implying that racial differences in primary care (and other) utilization tended to emerge after care was initiated, which may be consistent with evidence that even when access barriers are overcome, Black patients receive worse care and experience the health care system differently as a result of medical racism, discrimination by health care professionals, and differences in how physicians perceive them . For example, we found that Black adults were 48% less likely to receive treatment with pharmacotherapy for opioid use disorders, which was consistent with prior literature showing racialized access to these medications . While racial differences in the quality measures were nuanced (eg, Black enrollees had higher rates of preventive screenings but lower utilization of care for acute and chronic conditions), Black adults and children had higher emergency department utilization, including for avoidable reasons, reinforcing the idea that disparities in primary care reflect underuse.…”