In Low-Income Latino Patients, Post-Affordable Care Act Insurance Disparities May Be Reduced Even More than Broader National Estimates: Evidence from Oregon.
Early survey evidence suggests a reduction of disparities in insurance coverage between Latinos and non-Hispanic Whites post-Affordable Care Act (ACA). These findings may not describe the insurance status of vulnerable, low-income Latino populations served in community health centers (CHCs) over the course of this policy change. Cross-sectional surveys also may be of limited use in describing longitudinal phenomena such as changes in health insurance status.



Using electronic health record (EHR) data, we compared the insurance status of N = 42,392 low-income patients served in 23 CHCs in Oregon, by race/ethnicity and language, over a period of 6 years straddling the implementation of ACA-related Medicaid expansion on January 1, 2014.



Prior to 2014, Spanish-preferring Latinos were more likely to be uninsured than English-preferring Latinos and non-Hispanic Whites. Among uninsured patients who returned for at least one visit in 2014, Spanish-preferring Latinos had the largest increase in insurance coverage rates, and all three racial/ethnic/language groups had similar rates of insurance coverage. There were no racial/ethnic/language differences between those who did and did not have visit in 2014.



Among previously uninsured low-income patients returning to Oregon CHCs, insurance disparities were eliminated after Medicaid expansion, especially in Spanish-speaking Latinos. Further study is needed to understand the elimination of insurance disparities in this cohort.
Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Drive, Mail Code FM, Portland, OR, 97239, USA. heintzma@ohsu.edu.
John
J
Heintzman
Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Drive, Mail Code FM, Portland, OR, 97239, USA.
Steffani R
SR
Bailey
Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Drive, Mail Code FM, Portland, OR, 97239, USA.|OCHIN, Inc, 1881 SW Naito Pkwy, Portland, OR, 97201, USA.
Jennifer
J
DeVoe
OCHIN, Inc, 1881 SW Naito Pkwy, Portland, OR, 97201, USA.
Stuart
S
Cowburn
Virginia Garcia Memorial Health Center, 2935 SW Cedar Hills Blvd, Beaverton, OR, 97005, USA.
Tanya
T
Kapka
Oakland University William Beaumont School of Medicine, 2200 N Squirrel Rd, Rochester, MI, 48309, USA.
Truc-Vi
TV
Duong
Department of Family Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Drive, Mail Code FM, Portland, OR, 97239, USA.|Division of Biostatistics, Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Drive, Mail Code FM, Portland, OR, 97239, USA.
Miguel
M
Marino
D000328:Adult; D000368:Aged; D057286:Electronic Health Records; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009922:Oregon; D058991:Patient Protection and Affordable Care Act; D011203:Poverty / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
Affordable Care Act; Community health centers; Health insurance; Hispanic/Latino Americans