The impact of Medicaid funding structures on inequities in health care access for Latinos in New York, Florida, and Puerto Rico.
Hispanic or Latino
Patient Protection and Affordable Care Act
health services accessibility
medically uninsured
minority groups
poverty
Journal
Health services research
ISSN: 1475-6773
Titre abrégé: Health Serv Res
Pays: United States
ID NLM: 0053006
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
pubmed:
22
7
2022
medline:
16
11
2022
entrez:
21
7
2022
Statut:
ppublish
Résumé
To study the impact of Medicaid funding structures before and after the implementation of the Affordable Care Act (ACA) on health care access for Latinos in New York (Medicaid expansion), Florida (Medicaid non-expansion), and Puerto Rico (Medicaid block grant). Pooled state-level data for New York, Florida, and Puerto Rico from the 2011-2019 Behavioral Risk Factor Surveillance System and data from the 2011-2019 American Community Survey and Puerto Rico Community Survey. Cross-sectional study using probit with predicted margins to separately compare four health care access measures among Latinos in New York, Florida, and Puerto Rico (having health insurance coverage, having a personal doctor, delayed care due to cost, and having a routine checkup). We also used difference-in-differences to measure the probability percent change of having any health insurance and any public health insurance before (2011-2013) and after (2014-2019) the ACA implementation among citizen Latinos in low-income households. The sample consisted of Latinos aged 18-64 residing in New York, Florida, and Puerto Rico from 2011 to 2019. Latinos in Florida had the lowest probability of having health care access across all four measures and all time periods compared with those in New York and Puerto Rico. While Latinos in Puerto Rico had greater overall health care access compared with Latinos in both states, health care access in Puerto Rico did not change over time. Among citizen Latinos in low-income households, New York had the greatest post-ACA probability of having any health insurance and any public health insurance, with a growing disparity with Puerto Rico (9.7% any [1.6 SE], 5.2% public [1.8 SE]). Limited Medicaid eligibility (non-expansion of Florida's Medicaid program) and capped Medicaid funds (Puerto Rico's Medicaid block grant) contributed to reduced health care access over time, particularly for citizen Latinos in low-income households.
Identifiants
pubmed: 35861151
doi: 10.1111/1475-6773.14036
pmc: PMC9660415
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
172-182Subventions
Organisme : NIMHD NIH HHS
ID : R01 MD013866
Pays : United States
Informations de copyright
© 2022 Health Research and Educational Trust.
Références
Acad Pediatr. 2020 Jan - Feb;20(1):14-15
pubmed: 31404709
Am J Public Health. 2017 Dec;107(12):1900-1901
pubmed: 29116848
Int J Health Econ Manag. 2022 Mar;22(1):91-110
pubmed: 34427837
Health Serv Res. 2022 Dec;57 Suppl 2:172-182
pubmed: 35861151
JAMA Netw Open. 2022 Mar 1;5(3):e221476
pubmed: 35258582
Med Care. 1981 Dec;19(12):4-27
pubmed: 11643688
Med Care. 2016 Feb;54(2):140-6
pubmed: 26595227
Milbank Q. 2015 Sep;93(3):584-608
pubmed: 26350931
Am J Manag Care. 2019 Mar;25(3):129-134
pubmed: 30875181
Ann Am Thorac Soc. 2015 Dec;12(12):1760-3
pubmed: 26551268
Health Serv Res. 2018 Oct;53(5):3640-3656
pubmed: 29468669
Am Fam Physician. 2020 Jan 1;101(1):13-14
pubmed: 31894942
J Am Coll Cardiol. 2020 Apr 21;75(15):1857-1859
pubmed: 32299597