Department of Health Policy & Management, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South Room 31-299C, Box 951772, Los Angeles, CA, 90095, USA.
Department of Health Services Administration, University of Maryland, College Park, 3310A School of Public Health Building, College Park, MD, 20742-2611, USA.
J Immigr Minor Health. 2019 Apr;21(2):211-218. doi: 10.1007/s10903-018-0741-6.
We examine changes in health insurance coverage and access to and utilization of health care before and after the national implementation of the Patient Protection and Affordable Care Act (ACA) among the U.S. adult immigrant population. Data from the 2011-2016 National Health Interview Survey are used to compare adult respondents in 2011-2013 (before the ACA implementation) and 2014-2016 (after the ACA implementation). Multivariable logistic regression analyses are used to compare changes over time. This study shows that the ACA has closed the coverage gap that previously existed between U.S. citizens and non-citizen immigrants. We find that naturalized citizens, non-citizens with more than 5 years of U.S. residency, and non-citizens with 5 years or less of U.S. residency reduced their probability of being uninsured by 5.81, 9.13, and 8.23%, respectively, in the first 3 years of the ACA. Improvements in other measures of access and utilization were also observed.
我们研究了在美国成年移民群体中，在国家实施《患者保护与平价医疗法案》（ACA）前后，医疗保险覆盖范围以及获得和利用医疗保健服务的变化。本研究使用了 2011-2016 年全国健康访谈调查的数据，将 2011-2013 年（ACA 实施前）和 2014-2016 年（ACA 实施后）的成年受访者进行了比较。多变量逻辑回归分析用于比较随时间的变化。ACA 缩小了美国公民和非公民移民之间以前存在的覆盖差距。我们发现，入籍公民、在美国居住超过 5 年的非公民和在美国居住 5 年或以下的非公民，在 ACA 的头 3 年，其未参保的概率分别降低了 5.81%、9.13%和 8.23%。在获得和利用医疗保健服务的其他方面也观察到了改善。
