title: Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act.
abstract: OBJECTIVE
  We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA).
  
  
  METHODS
  We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland.
  
  
  RESULTS
  Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups.
  
  
  CONCLUSIONS
  Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions.
authors.affiliation: Salam Abdus is with Social and Scientific Systems, Silver Spring, MD. Kamila B. Mistry and Thomas M. Selden are with the Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Salam
authors.initials: S
authors.lastname: Abdus
authors.affiliation: Salam Abdus is with Social and Scientific Systems, Silver Spring, MD. Kamila B. Mistry and Thomas M. Selden are with the Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Kamila B
authors.initials: KB
authors.lastname: Mistry
authors.affiliation: Salam Abdus is with Social and Scientific Systems, Silver Spring, MD. Kamila B. Mistry and Thomas M. Selden are with the Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Selden
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D062265:Health Insurance Exchanges / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health; D008297:Male; D008396:Maryland; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States