Uninsured Rate Among Latinos Dropped Significantly in Medicaid Expansion States

The uninsured rate among Latinos dropped sharply under the Affordable Care Act (ACA), but there were stark differences between states that have expanded Medicaid and those that have not, according to a new report from the Commonwealth Fund.

The uninsured rate for working-age Latinos dropped from 36% in July-September 2013, to 23% in April-June 2014. The national uninsured rate for all working-age adults is now down to 15%. Historically, Latinos had the highest uninsured rates, particularly among adults speaking predominantly Spanish. That group’s uninsured rate fell from 49% to 30%. However, the largest gains came from the young and those with low incomes.

The uninsured rate for young Latinos (ages 19 to 34) fell from 43% in July-September of 2013 to 23% in April-June of 2014, according to the brief. Among families with incomes below $32,500 for a family of 4, the rate fell from 46% to 28%.

Coverage gains for Latinos were strongly associated with where they lived. In Medicaid expansion states, the uninsured rate declined from 35% to 17%. However, in states that chose not to expand Medicaid, the rate was statistically unchanged at 33%.

According to the report, HHS estimates 2 million uninsured Latinos would be eligible for Medicaid if the states they lived in had chosen to expand the program. Non-expansion states are home to a total of 20 million, with the vast majority (14 million) residing in Texas or Florida.

“For Latinos to fully benefit from the Affordable Care Act, however, expanding Medicaid will be key, as will be efforts by state and federal officials to raise awareness of the marketplaces among Latinos and provide assistance to those looking for health insurance,” Commonwealth Fund President David Blumenthal, MD, said in a statement.

In comparison, California, which has the largest Latino population, expanded Medicaid eligibility and invested in outreach efforts to educate residents. As a result, half of the state’s previously uninsured Latino population gained coverage since open enrollment began.

The report also found that Latinos were significantly less likely than non-Hispanic whites to visit the marketplace. However, once Latinos visited the marketplace, 58% found a plan they could afford compared with 38% of non-Hispanic whites.

“Success in reaching the remaining uninsured will depend largely on states’ decisions to expand Medicaid eligibility levels, on govern­ment and private educational outreach efforts, and on Latinos enrolling in the new coverage options available to them,” authors Michelle M. Doty, Petra W. Rasmussen, and Sara R. Collins wrote.