By John Heintzman, MD, MPH
One of the primary features of the Affordable Care Act (ACA) was the expansion of Medicaid in states that chose to do so. Oregon accepted these funds and expanded Medicaid to as many low-income people as possible. It is uncertain, however, if these expansions have affected all communities equitably. Our study, published in the Journal of Racial and Ethnic Health Disparities, aimed to see if income-eligible Latino and Spanish speaking patients with access to an Oregon community health center during the roll out of the Affordable Care Act gained insurance at the same rate as non-Hispanic whites.
The study found several things. First, prior to the Affordable Care Act, Spanish-speaking Latinos were more likely to be uninsured over several years than English-speaking Latinos and non-Hispanic Whites. However, after the ACA was implemented, Spanish-speaking Latinos had the greatest increase in obtaining Medicaid. In fact, our post-ACA analysis revealed no differences in insurance between the groups (Spanish-speaking Latinos, English-speaking Latinos, non-Hispanic Whites). There were also no differences between the groups that didn’t return (for instance, Latinos didn’t show up less frequently in clinic after the ACA) This was surprising, because we know that some of our clinics’ Latino population consist of recent immigrants, who are still ineligible for insurance. However, our findings suggest that clinics are efficient at not only helping patients getting insurance, but may be helpful reducing some of the common healthcare disparities we see in our country. More research is needed, though, to better understand exactly how our immigrant patients have experienced this major policy change.