Disparities persist in insurance coverage, source of care

While the Affordable Care Act has led to more people having health insurance in recent years, racial and ethnic disparities persist when it comes to health care access, according to presenters at a Wednesday Annual Meeting Session on “Racial/Ethnic Disparities in Health Care Access and Experiences.”

For example, more than 13 million previously uninsured U.S. adults aged 18-64 gained health coverage between 2013 and 2018, said presenter Michael Martinez, a statistician at the National Center for Health Statistics. He highlighted a study that looked at changes in racial and ethnic disparities in health care access and utilization from 2013 to 2018 among U.S. adults. His results tracked health care measures such as primary places of care, insurance status and doctor visitation frequency across minority groups.

“All [ethnic and racial] groups saw a decrease in the uninsured population access,” Martinez told attendees. “Only Hispanics showed improvement across all access measures, but still remain the lowest group across most of the measures.”

His slides showing graphs of health care access and use, “tell a consistent story,” he said. “There are still barriers to accessing utilization of care beyond health insurance.”

Hispanics continue to have one of the highest uninsurance rates in the country. Yelenna Rondon, a doctoral student at the University of Massachusetts at Lowell, presented findings about the impact of the ACA’s Medicaid expansion on health insurance coverage among Hispanic citizens and Hispanic noncitizens. Her findings indicate that expansion decreased insurance coverage among Hispanic citizens by an estimated 1.21% relative to noncitizens. Rondon acknowledged the counterintuitive nature of the results and explained they may be the result of increased coverage among Hispanic residents who are not citizens during the same time period.

The session also included revealing findings about sources of care for Asian Americans, the fastest growing demographic group in America. Among Medicaid beneficiaries, Asian Americans were significantly less likely to report a usual source of care than whites, said Kevin Nguyen, a doctoral student at Brown University School of Public Health.

“We can try to create either programs or policies that better connect patients to having a usual source of care,” he told attendees.

Presenter Sarah Booker, a research analyst at the United Network for Organ Sharing, offered encouraging news of a recent increase across minority groups in receiving liver and kidney donations from living donors.

“It’s encouraging that donations have increased across all racial and ethnic groups,” Booker said, noting racial and ethnic gaps still persist when it comes to organ donors and recipients. “More targeted strategies to reduce these disparities are needed.”