Impact of the ACA Individual Mandate Elimination on Latino Individuals

While health insurance coverage and access to care improved from the Patient Protection and Affordable Care Act (ACA), the 2019 elimination of the individual mandate negatively impacted Latino populations, according to study findings published in JAMA Network Open.

Researchers analyzed National Health Interview Survey (NHIS) data and grouped findings by 2011-2013 (the period before the national ACA implementation), 2014-2015 (the start of implementation), and 2019 (when the mandate was eliminated). Study participants were aged between 18 to 64 years and results were nationally representative.

The 4 measures of note during these periods were identified by researchers as being currently uninsured, having a usual source of care, any emergency department (ED) visit, or delay of care due to cost in the past year.

According to study authors, the period before the ACA was implemented until the period the individual insurance mandate was enforced showed a decrease in the percentage of uninsured individuals, but the 2019 elimination caused a 3-percentage point increase in the probability of being uninsured for all individuals.

“Between the periods of 2016-2018 and 2019, Latino persons had a 5–percentage-point increase in the probability of being uninsured (from 25.0% to 30.1%), and that probability was more than double the probability for Black (14.0%) and White (9.9%) populations in 2019,” stated study authors. “For ED visits, Black and Latino populations experienced a 3–percentage point and 2–percentage point increase between 2016-2018 and 2019 (Black individuals, from 27.0% to 29.5%; Latino individuals, from 19.0% to 21.4%).”

Researchers noted that the Latino population had an increase in the probabilities of being uninsured, delaying care due to cost, and having and ED visit after the mandate elimination, but had an increase in the probability of having a usual source of care.

Study authors concluded, “The findings of this cross-sectional study suggest that encouraging states to expand Medicaid and bolster the health care safety net to improve community-based services will also be beneficial in reversing health care inequities for Latino populations.”

Reference:
Ortega AN, Chen J, Roby DH, et al. Changes in coverage and cost-related delays in care for Latino individuals after elimination of the Affordable Care Act’s individual mandate. JAMA Netw Open. 2022;5(3):e221476. doi:10.1001/jamanetworkopen.2022.1476