In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon

  • John Heintzman
  • Steffani R. Bailey
  • Jennifer DeVoe
  • Stuart Cowburn
  • Tanya Kapka
  • Truc-Vi Duong
  • Miguel Marino
Article

Abstract

Background

Early survey evidence suggests a reduction of disparities in insurance coverage between Latinos and non-Hispanic Whites post-Affordable Care Act (ACA). These findings may not describe the insurance status of vulnerable, low-income Latino populations served in community health centers (CHCs) over the course of this policy change. Cross-sectional surveys also may be of limited use in describing longitudinal phenomena such as changes in health insurance status.

Methods

Using electronic health record (EHR) data, we compared the insurance status of N = 42,392 low-income patients served in 23 CHCs in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion on January 1, 2014.

Findings

Prior to 2014, Spanish-preferring Latinos were more likely to be uninsured than English-preferring Latinos and non-Hispanic Whites. Among uninsured patients who returned for at least one visit in 2014, Spanish-preferring Latinos had the largest increase in insurance coverage rates, and all three racial/ethnic/language groups had similar rates of insurance coverage. There were no racial/ethnic/language differences between those who did and did not have visit in 2014.

Conclusion

Among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos. Further study is needed to understand the elimination of insurance disparities in this cohort.

Keywords

Health insurance Hispanic/Latino Americans Affordable Care Act Community health centers 

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Copyright information

© W. Montague Cobb-NMA Health Institute 2016

Authors and Affiliations

  • John Heintzman
    • 1
  • Steffani R. Bailey
    • 1
  • Jennifer DeVoe
    • 1
    • 2
  • Stuart Cowburn
    • 2
  • Tanya Kapka
    • 3
  • Truc-Vi Duong
    • 4
  • Miguel Marino
    • 1
    • 5
  1. 1.Department of Family MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.OCHIN, IncPortlandUSA
  3. 3.Virginia Garcia Memorial Health CenterBeavertonUSA
  4. 4.Oakland University William Beaumont School of MedicineRochesterUSA
  5. 5.Division of Biostatistics, Department of Public Health and Preventive MedicineOregon Health and Science UniversityPortlandUSA

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