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Objective: The objective of this study was to examine changes in health care access and utilization for White, Asian, and Latino immigrants associated with the implementation of the Patient Protection and Affordable Care Act (ACA) in California. Study Design: Using the 2011-2013 and 2015-2017 California Health Interview Survey, we examined changes in 2 health care access and 2 utilization measures among 3 immigrant racial/ethnic groups. We estimated the unadjusted and adjusted percentage point changes in the pre-ACA and post-ACA periods. Adjusted estimates were obtained using linear probability models controlling for predisposing, enabling, and need factors. Results: After the ACA was nationally implemented in 2014, rates of insurance increased for non-Latino (NL) White, NL Asian, and Latino immigrant groups in California. Latino immigrants had the largest increase in insurance coverage (14.3 percentage points), followed by NL Asian immigrants (9.9 percentage points) and NL White immigrants (9.2 percentage points). Despite benefitting from the largest increase in insurance coverage, the proportion of insured Latino immigrants was still lower than that of NL White and NL Asian immigrants. Latino immigrants reported a small but significant decrease in the usual source of care (-2.8 percentage points) and an increase in emergency department utilization (2.9 percentage points) after the ACA. No significant changes were found after the ACA in health care access and utilization among NL White and NL Asian immigrants. Conclusions: Insurance coverage increased significantly for these 3 immigrant groups after the ACA. While Latino immigrants had the largest gain in insurance coverage, the proportion of Latino immigrants with insurance remained the lowest among the 3 immigrant racial/ethnic groups.
The Affordable Care Act and Health Care Access and Utilization Among White, Asian, and Latino Immigrants in California
Creators
Jun Chu - University of California, Los Angeles
Alexander N. Ortega - Drexel University
Sungchul Park - Drexel University
Arturo Vargas-Bustamante - Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA.
Dylan H. Roby - University of Mary
Publication Details
Medical care, v 59(9), pp 762-767
Publisher
Lippincott Williams & Wilkins
Number of pages
6
Resource Type
Journal article
Language
English
Academic Unit
Health Management and Policy
Web of Science ID
WOS:000685227400002
Scopus ID
2-s2.0-85107980408
Other Identifier
991019167567504721
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