Summary

Published Date: June 03, 2021

Summary: The objective of this study was to examine changes in health care access and utilization for white, Asian, and Latino immigrants associated with the implementation of the Patient Protection and Affordable Care Act (ACA) in California. Researchers examined changes in two health care access and two utilization measures among three immigrant racial/ethnic groups. They estimated the unadjusted and adjusted percentage point changes in the pre-ACA and post-ACA periods.

Findings: After the ACA was nationally implemented in 2014, rates of insurance increased for non-Latino (NL) white, NL Asian, and Latino immigrant groups in California. Latino immigrants had the largest increase in insurance coverage (14.3 percentage points), followed by NL Asian immigrants (9.9 percentage points), and NL White immigrants (9.2 percentage points). Despite benefitting from the largest increase in insurance coverage, the proportion of insured Latino immigrants was still lower than that of NL white and NL Asian immigrants. Latino immigrants reported a small but significant decrease in the usual source of care (-2.8 percentage points) and an increase in emergency department utilization (2.9 percentage points) after the ACA. No significant changes were found after the ACA in health care access and utilization among NL White and NL Asian immigrants.

Insurance coverage increased significantly for these three immigrant groups after the ACA. While Latino immigrants had the largest gain in insurance coverage, the proportion of Latino immigrants with insurance remained the lowest among the three immigrant racial/ethnic groups.

This study uses data from the 2011­–2013 and 2015­–2017 California Health Interview Surveys (CHIS).

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