title: Medicaid Expansion and Healthcare Access: Lessons from Asian American and Pacific Islander Experiences in California.
abstract: Medicaid coverage increases access to care and improves health outcomes for disadvantaged populations. Yet disparities in enrollment and access to care persist. To understand the facilitators and barriers of Medicaid enrollment and accessing care under the Affordable Care Act for disadvantaged Asian Americans and Pacific Islanders. Focus groups and key informant interviews were conducted. Informational barriers to accessing care were pervasive among most new enrollees. Immigrants with limited English proficiency experienced disproportionate difficulties in enrolling and accessing care post enrollment. The simplified, income-based Medicaid eligibility streamlined the enrollment process, but system errors in determining Medicaid eligibility denied coverage for some eligible individuals. To improve access to care, health plans, government agencies, and community organizations might coordinate more closely. Federal and state laws that mandate language assistance by health plans might be enforced to improve access to care for linguistic minorities.
authors.affiliation: Alcohol Research Group, Public Health Institute, 6001 Shellmound St. Suite 450, Emeryville, CA, 94608, USA. wcook@arg.org.
authors.forename: Won Kim
authors.identifier: 0000-0002-0390-297X
authors.initials: WK
authors.lastname: Cook
authors.affiliation: Policy Advocacy Branch, Asian & Pacific Islander American Health Forum, Oakland, CA, USA.
authors.forename: Iyanrick
authors.initials: I
authors.lastname: John
authors.affiliation: Health Policy and Planning Program, San Mateo County Health System, San Mateo, CA, USA.
authors.forename: Corina
authors.initials: C
authors.lastname: Chung
authors.affiliation: School of Public Health, University of California, Berkeley, CA, USA.
authors.forename: Winston
authors.initials: W
authors.lastname: Tseng
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA.
authors.forename: Juliet P
authors.initials: JP
authors.lastname: Lee
mesh_terms: D001213:Asian; D002140:California; D035082:Federal Government; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008484:Medicaid / Q000458:organization & administration*; D044468:Native Hawaiian or Pacific Islander; D011203:Poverty; D013219:State Government; D014481:United States
keywords: Asian American health; Health care access; Language access; Medicaid; Pacific Islander health