title: Massachusetts' health care reform increased access to care for Hispanics, but disparities remain.
abstract: Hispanics are more likely than any other racial or ethnic group in the United States to lack health insurance. This paper draws on quantitative and qualitative research to evaluate the extent to which health reforms in Massachusetts, a model for the Affordable Care Act of 2010, have reduced disparities in insurance coverage and access to health care. We found that rates of coverage and the likelihood of having a usual provider increased dramatically for Massachusetts Hispanics after the state's reforms, but disparities remained. The increase in insurance coverage among Hispanics was more than double that experienced by non-Hispanic whites. Even so, in 2009, 78.9 percent of Hispanics had coverage, versus 96 percent of non-Hispanic whites. Language and other cultural factors remained significant barriers: Only 66.6 percent of Hispanics with limited proficiency in English were insured. One-third of Spanish-speaking Hispanics still did not have a personal provider in 2009, and 26.8 percent reported not seeing a doctor because of cost, up from 18.9 percent in 2005. We suggest ways to reduce such disparities through national health care reform, including simplified enrollment and reenrollment processes and assistance in finding a provider and navigating an unfamiliar care system.
authors.affiliation: JSI Research and Training Institute, Boston, Massachusetts, USA. jmaxwell@jsi.com
authors.forename: James
authors.initials: J
authors.lastname: Maxwell
authors.forename: Dharma E
authors.initials: DE
authors.lastname: Cortés
authors.forename: Karen L
authors.initials: KL
authors.lastname: Schneider
authors.forename: Anna
authors.initials: A
authors.lastname: Graves
authors.forename: Brian
authors.initials: B
authors.lastname: Rosman
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D017144:Focus Groups; D018166:Health Care Reform; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007407:Interviews as Topic; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D055815:Young Adult