4.4 Article

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform

Journal

HEALTH SERVICES RESEARCH
Volume 53, Issue 3, Pages 1373-1386

Publisher

WILEY
DOI: 10.1111/1475-6773.12733

Keywords

Insurance; racial; ethnic disparities; health reform

Funding

  1. Harvard University Graduate School of Arts and Science
  2. T.H. Chan School of Public Health

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ObjectiveTo examine the patterns of insurance coverage among nine Latino subgroups and assess heterogeneous effects of the Affordable Care Act (ACA) among these groups. Data SourcesAmerican Community Survey (2010-2014). Study DesignWe examined pre-ACA disparities in coverage using linear probability models. Then, we used interrupted time series and triple-difference models to evaluate coverage changes associated with the ACA and Medicaid expansion, respectively. Principal FindingsPre-ACA coverage disparities between Latino subgroups were nearly 30 percentage pointslarger than the gap between whites and Latinos as a whole. Coverage changes associated with the ACA and Medicaid expansion differed significantly between subgroups, with the largest gains among South Americans, Central Americans, and Mexicans. ConclusionsLatino subgroups show marked heterogeneity in baseline coverage rates and responses to the ACA.

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