University of Massachusetts Boston, Boston, MA, USA.
Med Care Res Rev. 2020 Oct;77(5):461-473. doi: 10.1177/1077558718808709. Epub 2018 Oct 26.
Before the Affordable Care Act Medicaid expansion, nonelderly childless adults were not generally eligible for Medicaid regardless of their income, and Hispanics had much higher uninsured rates than other racial/ethnic subgroups. We estimated difference-in-differences models on Behavioral Risk Factor Surveillance data (2011-2016) to estimate the impacts of Medicaid expansion on racial/ethnic disparities in insurance coverage, access to care, and health status in this vulnerable subpopulation. Uninsured rates among all poor childless adults declined by roughly 9 percentage points more in states that expanded Medicaid. While expansion also had favorable impacts on most access and health outcomes among Whites in expansion states, there were relatively few such impacts among Blacks and Hispanics. Through 2016, Affordable Care Act Medicaid expansion was more effective in improving access and health outcomes among White low-income childless adults than mitigating racial/ethnic disparities.
在平价医疗法案 Medicaid 扩展计划之前，无论收入如何，非老年无子女的成年人通常没有资格获得 Medicaid，而且西班牙裔的无保险率比其他种族/族裔群体高得多。我们使用行为风险因素监测数据（2011-2016 年）进行了差异中的差异模型估计，以估计 Medicaid 扩展计划对这一脆弱人群的保险覆盖范围、获得医疗保健的机会和健康状况方面的种族/族裔差异的影响。在扩大 Medicaid 的州，所有贫困无子女成年人的未保险率下降了约 9 个百分点。虽然 Medicaid 扩展计划在扩大州的白人中也对大多数获得医疗保健和健康结果产生了有利影响，但在黑人和西班牙裔中，这种影响相对较少。截至 2016 年，平价医疗法案 Medicaid 扩展计划在改善白人低收入无子女成年人的获得医疗保健和健康结果方面比减轻种族/族裔差异更有效。
