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

Abstract

Objective: To examine the 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—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.