Abstract
Following the Affordable Care Act (ACA) health insurance expansions, this study asks: did racial/ethnic group disparities in access to care remain? And specifically, did Latinos experience worse access to care after the ACA expansions compared to other racial/ethnic groups? Dataset: 2015 California Health Interview Survey (n=21,034; N=29,083,000). Participants: Adults, ages 18 and older, in California. Analyses: Bivariate chi-square tests and logistic multivariate regressions, including stratification by insurance. Bivariate tests showed associations between racial/ethnic group and access to care. Latinos had lowest rates of having a usual source of care among uninsured (49.5%) and job-based coverage (85.2%). One-fifth of uninsured non-Latino whites (21%) report foregoing needed care. In the multivariate models, non-Latino whites had significantly higher odds of having a usual source of care (OR=1.32; p<0.05), but also of foregoing needed care (OR=1.43; p<0.05), than Latinos. Asian Americans had significantly lower odds of visiting a doctor in the past year (OR=0.65; p<0.05) than Latino adults. Following the ACA, disparities among racial/ethnic groups have become more complex. While Latino adults still have lower rates of having a usual source of care, Asian American adults have low rates of visiting a doctor, and non-Latino whites have high rates of foregoing needed care. Further research into the causes of difficulties in accessing care is needed, as health insurance expansions did not create health equity in solving access to care problems.
Highlights
The Patient Protection and Affordable Care Act of 2010 (ACA) fueled substantial growth in health insurance enrollment, due to new insurance options available nationwide
Using the most recent data available from California’s large population-based survey, the 2015 California Health Interview Survey (CHIS), we studied the impact of the ACA health insurance enrollment growth on access to care among the different racial and ethnic groups in the state
These proportions show the racial ethnic diversity of the adult population, with significant populations of all groups, people who self-reported African American in the state was below 6%
Summary
The Patient Protection and Affordable Care Act of 2010 (ACA) fueled substantial growth in health insurance enrollment, due to new insurance options available nationwide. Following the Affordable Care Act (ACA) health insurance expansions, this study asks: did racial/ethnic group disparities in access to care remain? Did Latinos experience worse access to care after the ACA expansions compared to other racial/ethnic groups? Non-Latino whites had significantly higher odds of having a usual source of care (OR=1.32; p
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