Racial and ethnic disparities in services and the patient protection and affordable care act

S. Abdus, K.B. Mistry and Thomas Selden

American Journal of Public Health, 2015, vol. 105, S668-S675

Abstract: Objectives: We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods: We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results: Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions: Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions.

Keywords: adult; ancestry group; ethnic group; female; health care delivery; health care policy; health insurance; human; insurance; legislation and jurisprudence; male; Maryland; medicaid; middle aged; patient care; preventive health service; statistics and numerical data; United States, Adult; Continental Population Groups; Ethnic Groups; Female; Health Insurance Exchanges; Health Services Accessibility; Humans; Insurance Coverage; Insurance, Health; Male; Maryland; Medicaid; Middle Aged; Patient Protection and Affordable Care Act; Patient-Centered Care; Preventive Health Services; United States (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302892_6

DOI: 10.2105/AJPH.2015.302892

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