Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform

Abstract

Abstract: Objective: To examine patterns of insurance coverage among nine Latino subgroups and assess heterogeneous effects of the Affordable Care Act (ACA) among these groups. Data sources: American Community Survey (2010-2014). Study design: We examined pre-ACA disparities in coverage using linear probability models. Then we used interrupted time series and triple-difference models to evaluate coverage changes associated with the ACA and Medicaid expansion, respectively. Principal findings: Pre-ACA coverage disparities between Latino subgroups were nearly 30 percentage points, which was larger than the gap between Whites and Latinos as a whole. Coverage changes associated with the ACA and Medicaid expansion differed significantly between subgroups, with the largest gains among South Americans, Central Americans, and Mexicans. Conclusions: Latino subgroups show marked heterogeneity in baseline coverage rates and responses to the ACA.