In low-income Latino patients, post-affordable care act insurance disparities may be reduced even more than broader national estimates: Evidence from Oregon

John Heintzman, Steffani R. Bailey, Jennifer Devoe, Stuart Cowburn, Tanya Kapka, Truc Vi Duong, Miguel Marino

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background Early survey evidence suggests a reduction of disparities in insurance coverage between Latinos and non- Hispanic Whites post-Affordable Care Act (ACA). These findings may not describe the insurance status of vulnerable, low-income Latino populations served in community health centers (CHCs) over the course of this policy change. Crosssectional surveys also may be of limited use in describing longitudinal phenomena such as changes in health insurance status. Methods Using electronic health record (EHR) data, we compared the insurance status of N = 42,392 low-income patients served in 23 CHCs in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion on January 1, 2014. Findings Prior to 2014, Spanish-preferring Latinos were more likely to be uninsured than English-preferring Latinos and non-Hispanic Whites. Among uninsured patients who returned for at least one visit in 2014, Spanish-preferring Latinos had the largest increase in insurance coverage rates, and all three racial/ethnic/language groups had similar rates of insurance coverage. There were no racial/ethnic/language differences between those who did and did not have visit in 2014. Conclusion Among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanishspeaking Latinos. Further study is needed to understand the elimination of insurance disparities in this cohort.

Original languageEnglish (US)
Pages (from-to)329-336
Number of pages8
JournalJournal of Racial and Ethnic Health Disparities
Volume4
Issue number3
DOIs
StatePublished - Apr 22 2017

Keywords

  • Affordable Care Act
  • Community health centers
  • Health insurance
  • Hispanic/Latino Americans

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

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