title: Would safety-net expansions offset reduced access resulting from lost insurance coverage? Race/ethnicity differences.
abstract: This study simulated whether increased community health center (CHC) funding under the Bush administration narrowed racial/ethnic gaps in access to care among low-income people. Expanded CHC funding resulted in small increases in access to care, more so for minorities than for whites. Spanish-speaking Hispanics had the largest improvements in access in the simulation. However, minorities experienced bigger drops in insurance coverage. The net result was no improvements in the access measures for Spanish-speaking Hispanics and slight decreases in access for whites, English-speaking Hispanics, and African Americans. Access gaps either remained the same or worsened slightly for English-speaking Hispanics and African Americans relative to whites.
authors.affiliation: Center for Studying Health System Change, Washington, DC, USA. jhadley@hschange.org
authors.forename: Jack
authors.initials: J
authors.lastname: Hadley
authors.forename: Peter
authors.initials: P
authors.lastname: Cunningham
authors.forename: J Lee
authors.initials: JL
authors.lastname: Hargraves
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D003151:Community Health Centers / Q000191:economics* / Q000706:statistics & numerical data; D003198:Computer Simulation; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000145:classification / Q000191:economics* / Q000639:trends; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D017057:Medically Uninsured / Q000208:ethnology*; D008913:Minority Groups / Q000706:statistics & numerical data*; D011203:Poverty / Q000208:ethnology*; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data