Impact of the Affordable Care Act on Health Care Access and Utilization Among Latinos

Abstract

Introduction: In the United States, Latinos have poorer access to and utilization of health care than non-Latino whites. The Patient Protection and Affordable Care Act (ACA) may reduce these disparities. The ACA's impact among Latino subgroups is unknown.

Methods: Using the 2011 to 2015 National Health Interview Survey, we examined access to and utilization of health care by Latino subgroups (18-64 years old). Subgroups were defined by Latino heritage group, citizenship status, and language use. Measures of access and utilization included insurance status, delaying medical care, forgoing medical care, visiting the emergency department, and visiting a physician. Logistic regression models were used to estimate the odds of the outcomes. Time period and subgroup interaction terms were used to test the effects of the ACA.

Results: Mexicans and Central Americans had lower odds of being insured than did non-Latino whites. After ACA implementation, most reductions in disparities occurred between Puerto Ricans and non-Latino whites. Limited impact of the ACA was observed by language and citizenship status.

Conclusions: The ACA has reduced gaps in access to and utilization of health care for some Latino population subgroups. Remaining disparities necessitate policy solutions that move beyond the ACA, particularly for groups excluded from coverage options, such as noncitizens.

Keywords: Emergency Service; Hispanic Americans; Hospital; Insurance Coverage; Language; Logistic Models; Patient Protection and Affordable Care Act; Surveys and Questionnaires.