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

Health Aff (Millwood). 2018 Sep;37(9):1400-1408. doi: 10.1377/hlthaff.2018.0416.

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.

Keywords: Access To Care; Affordable Care Act; Disparities; Health Reform; Latinos.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • California
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Health Surveys
  • Healthcare Disparities* / ethnology
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Insurance Coverage / statistics & numerical data
  • Insurance, Health / statistics & numerical data
  • Male
  • Mexico / ethnology
  • Middle Aged
  • Patient Protection and Affordable Care Act / statistics & numerical data*
  • Undocumented Immigrants / statistics & numerical data*
  • United States