The American Rescue Plan Act and Access to Health Care for Latinos According to Citizenship Status.

IF 3.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Medical Care Pub Date : 2024-12-27 DOI:10.1097/MLR.0000000000002107
Damaris Lopez Mercado, Karoline Mortensen, Alexandra C Rivera-González, Jim P Stimpson, Arturo Vargas Bustamante, Dylan H Roby, Jie Chen, Clara B Barajas, Alexander N Ortega
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Abstract

Objective: We studied patterns in health care access between Latino and non-Latino White adults according to citizenship status before and after the American Rescue Plan Act (ARPA) of 2021 was enacted to determine whether inequities changed.

Methods: This study used 2019-2022 National Health Survey Interview data. Differences in predicted probabilities from logistic regression models were used to estimate changes in health care access outcomes (any insurance coverage, private insurance coverage, delaying care due to cost, and having a usual source of care) among Latino citizens, Latino noncitizens, and non-Latino White citizens in periods before and after ARPA's enactment (2019-2020 vs 2021-2022).

Results: Adjusted models observed that inequities in health care access did not change between Latino and non-Latino White citizens from the 2019-2020 period to the 2021-2022 period. Moreover, the health insurance gap widened by 5.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 5.2 percentage points between Latino noncitizens and Latino citizens (P < 0.05) from the 2019-2020 period to the 2021-2022 period. The private insurance coverage gap widened by 6.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 6.9 percentage points between Latino noncitizens and Latino citizens (P < 0.01) from the 2019-2020 period to the 2021-2022 period.

Conclusion: ARPA may have helped increase White citizens' insurance coverage, but this benefit did not extend to Latinos, regardless of citizenship status. Developing more inclusive health policies that do not have restrictions based on citizenship and legal authorization status is an important step toward reducing health care inequities.

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《美国救援计划法案》和根据公民身份为拉丁美洲人提供医疗保健。
目的:研究2021年《美国救援计划法案》(ARPA)颁布前后,拉丁裔和非拉丁裔白人成年人根据公民身份获得医疗服务的模式,以确定不平等是否发生了变化。方法:本研究使用2019-2022年全国健康调查访谈数据。使用逻辑回归模型预测概率的差异来估计拉丁裔公民、拉丁裔非公民和非拉丁裔白人公民在ARPA颁布前后(2019-2020 vs 2021-2022)期间医疗保健可及性结果的变化(任何保险覆盖范围、私人保险覆盖范围、因成本而延迟护理和拥有常规护理来源)。结果:调整后的模型观察到,从2019-2020年期间到2021-2022年期间,拉丁裔和非拉丁裔白人公民之间的医疗保健可及性不平等没有变化。此外,从2019-2020年到2021-2022年期间,拉丁裔非公民与非拉丁裔白人公民之间的健康保险差距扩大了5.8个百分点(P < 0.01),拉丁裔非公民与拉丁裔公民之间的健康保险差距扩大了5.2个百分点(P < 0.05)。从2019-2020年到2021-2022年,拉丁裔非公民与非拉丁裔白人公民之间的私人保险覆盖率差距扩大了6.8个百分点(P < 0.01),拉丁裔非公民与拉丁裔公民之间的差距扩大了6.9个百分点(P < 0.01)。结论:ARPA可能有助于增加白人公民的保险覆盖率,但这种好处并没有延伸到拉丁美洲人,无论其公民身份如何。制定更具包容性的卫生政策,不设基于公民身份和法律授权地位的限制,是朝着减少卫生保健不平等迈出的重要一步。
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来源期刊
Medical Care
Medical Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
3.30%
发文量
228
审稿时长
3-8 weeks
期刊介绍: Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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