Member Research and Reports

Member Research and Reports

Drexel Study: ACA Improved Youth Health Insurance Coverage but Disparities Persist for Latino Youth

Researchers at the Dornsife School of Public Health found Insurance coverage and well-child visits significantly improved for youth under the Patient Protection and Affordable Care Act. Non-Latino White and Black and Latino youth all showed improvements, but Latino youth continue to have the worst patterns of access and utilization.

Dr. Alex Ortega, professor at Drexel University, led a team that examined national survey results of more than 60,000 youth — who ranged in age from birth to 17 years old — to determine the effect the Affordable Care Act had on children according to race, ethnicity, and family poverty level. The team’s analysis looked at the period after national implementation of the ACA (years 2011-2013 versus years 2014-2015).

[Photo: Dr. Alex Ortega]

They hoped to discover whether the health law increased insurance coverage and improved health care access, as well as whether the large disparities that exist between Latino children and others were reduced in a significant way.

The post-ACA period was associated with improvements in access and utilization relative to the pre-ACA period. All youth were significantly less likely to be uninsured and more likely to have had a well-child visit. However, the data showed that insurance rates still remain markedly lower for Latino children when compared with their peers of different races. Improvements in Latino youth coverage weren’t enough to narrow the significant gap between them, and White, and Black children.

After the full implementation of the law, the portion of White and Black youth who did not have health insurance fell from five to four percent. But Latino children experienced a drop three times that, going from 12 to nine percent, according to the study, which was published in Academic Pediatrics.

Latino youth had the largest absolute gain in insurance coverage, but still had the highest absolute levels of uninsurance in the post-ACA period and had significant inequities in coverage compared with Whites. In 2011, for example, the uninsurance rate among Latino youth was 10 percent, or 2.5 times the rate for White youth (four percent). By 2015, uninsurance among Latino youth had decreased to six percent, but was still three times that of White youth (twp perceny).

Black youth experienced a marked closing of the disparities between them and White youth when it came to insurance coverage after the law was implemented. But while Latino children may have benefitted the most from a 25 percent reduction in uninsurance, they are still more than twice as likely to lack insurance coverage.

The full study published in Academic Pediatrics — co-authored by Dr. Ryan McKenna, and Dr. Brent Langellier, of Drexel; Dr. Jie Chen, and Dr. Dylan Roby, of the University of Maryland; and Dr. Héctor Alcalá, of Stony Brook University.