Medicaid expansion and ethnoracial disparities in health insurance coverage

Abstract

ABSTRACTMedicaid expansion, as part of the Patient Protection and Affordable Care Act (PPACA), was touted by many policymakers as a potentially powerful force for reducing ethnoracial disparities in health insurance coverage. Using a unique county-level dataset at two time points (before and after the passage of the PPACA), we test whether Medicaid Expansion predicted change in ethnoracial disparities. Specifically, we use fixed-effect regression models to predict the Black-white, Hispanic-white, and Asian-white disparities in health insurance coverage. Using states that did not expand Medicaid as a counterfactual, our models show that this policy expansion was not significantly associated with a decrease in ethnoracial health insurance disparities. Overall, these findings suggest the need for scholars and policymakers to be more cautious and tempered about Medicaid expansion’s relationship with ethnoracial disparities in health insurance coverage. We discuss the implications of these findings for research on ethnoracial health insurance disparities, as well as policy efforts to increase coverage in minority communities.