title: Health Benefits Mandates and Their Potential Impacts on Racial/Ethnic Group Disparities in Insurance Markets.
abstract: Addressing racial/ethnic group disparities in health insurance benefits through legislative mandates requires attention to the different proportions of racial/ethnic groups among insurance markets. This necessary baseline data, however, has proven difficult to measure. We applied racial/ethnic data from the 2009 California Health Interview Survey to the 2012 California Health Benefits Review Program Cost and Coverage Model to determine the racial/ethnic composition of ten health insurance market segments. We found disproportional representation of racial/ethnic groups by segment, thus affecting the health insurance impacts of benefit mandates. California's Medicaid program is disproportionately Latino (60 % in Medi-Cal, compared to 39 % for the entire population), and the individual insurance market is disproportionately non-Latino white. Gender differences also exist. Mandates could unintentionally increase insurance coverage racial/ethnic disparities. Policymakers should consider the distribution of existing racial/ethnic disparities as criteria for legislative action on benefit mandates across health insurance markets.
authors.affiliation: Department of Health Science, California State University Fullerton, 800 N. State College Boulevard, Fullerton, CA, 92831, USA. scharles@fullerton.edu.
authors.forename: Shana Alex
authors.initials: SA
authors.lastname: Charles
authors.affiliation: Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
authors.forename: Ninez
authors.initials: N
authors.lastname: Ponce
authors.affiliation: Department of Family and Community Medicine, UC Davis, Davis, CA, USA.
authors.forename: Dominique
authors.initials: D
authors.lastname: Ritley
authors.affiliation: School of Public Health, UC Berkeley, Berkeley, CA, USA.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Guendelman
authors.affiliation: Center for Healthcare Policy, UC San Diego, San Diego, CA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kempster
authors.affiliation: California Health Benefits Review Program, Oakland, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Lewis
authors.affiliation: Department of Family and Community Medicine, UC Davis, Davis, CA, USA.
authors.forename: Joy
authors.initials: J
authors.lastname: Melnikow
mesh_terms: D000328:Adult; D002140:California; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States
keywords: Benefit mandates; Health insurance; Racial/ethnic group disparities; State health policy