​Authors examined changes in health insurance coverage and access to and use of health care among adult (ages 18–64) Latinos in the U.S. before (2007–13) and after (2014–16) implementation of the main provisions of the Affordable Care Act. Data from the California Health Interview Survey were used to compare respondents in the two periods. Multivariable and decomposition regression analyses were used to investigate the role of documentation status in access disparities between Mexicans and other Latinos in California.

Findings show that after the implementation of these provisions in California, insurance coverage increased for U.S.- and foreign-born Latinos, including undocumented Latinos. Decomposition analyses showed that after implementation, disparities between Mexicans and other Latinos declined with respect to having coverage and a usual source of care. Without the implementation of these provisions in 2014, these disparities would have been 5.76 percent and 0.31 percent larger, respectively.

In contrast, legal documentation status was positively associated with disparities between Mexicans and other Latinos in having coverage and physician visits. If Mexican Latinos had had the same share of undocumented immigrants as other Latinos, disparities in health insurance coverage would have declined by 24.17 percent.