The Affordable Care Act Reduces Hypertension Treatment Disparities for Mexican-heritage Latinos.

Abstract

Mexican-heritage Latinos have lower prevalence of hypertension, but have worse patterns of treatment and control compared with non-Latino whites. This study examined the impact of the Affordable Care Act (ACA) insurance expansion on reducing disparities in treatment and medication use among Mexican-heritage Latinos with hypertension. Using the 2009-2014 waves of the California Health Interview Survey, we examine health care access, utilization, and medication use among Mexican-heritage Latinos and non-Latino whites with hypertension. Multivariable logistic regression analyses were performed to adjust for socioeconomic and demographic factors. Interactions between race/ethnicity and year variables were conducted to capture the effects of the passage of the ACA. Among those with hypertension, the full implementation of the ACA (year 2014) is associated with a greater likelihood of being insured, but the race/ethnicity interaction indicates that this gain is less substantial for Mexican-heritage Latinos. The odds of having a usual source of care other than the emergency department increased after the passage of the ACA, and interaction effects indicate that this gain was more substantial for Mexican-heritage Latinos. The odds of having any physician visit and taking blood pressure mediations decreased among non-Latino whites but increased among Mexican-heritage Latinos. The implementation of the ACA in California has helped reduce some of the disparities in health care access, utilization, and medication use between non-Latino whites and Mexican-heritage Latinos with hypertension. However, sustained progress is threatened by looming repeals of ACA provisions.