Medicaid Expansion and Healthcare Access: Lessons from Asian American and Pacific Islander Experiences in California

Abstract

Medicaid coverage increases access to care and improves health outcomes for disadvantaged populations. Yet disparities in enrollment and access to care persist. To understand the facilitators and barriers of Medicaid enrollment and accessing care under the Affordable Care Act for disadvantaged Asian Americans and Pacific Islanders. Focus groups and key informant interviews were conducted. Informational barriers to accessing care were pervasive among most new enrollees. Immigrants with limited English proficiency experienced disproportionate difficulties in enrolling and accessing care post enrollment. The simplified, income-based Medicaid eligibility streamlined the enrollment process, but system errors in determining Medicaid eligibility denied coverage for some eligible individuals. To improve access to care, health plans, government agencies, and community organizations might coordinate more closely. Federal and state laws that mandate language assistance by health plans might be enforced to improve access to care for linguistic minorities.