While more Americans have health insurance following the expansion of the Affordable Care Act, Hispanic adults have realized some of the biggest gains in access to medical care, a new government report shows.
Approximately 34 percent of Hispanic adults were uninsured in 2014, compared with 41 percent in 2013, according to the U.S. Centers for Disease Control and Prevention report, which was released Wednesday.
In 2014, Hispanic adults were also more likely to have seen or talked to a health care professional in the past 12 months, and they were less likely to have skipped needed medical care due to cost, according to the report in the NCHS Data Brief.
Despite these gains, Hispanic adults are still more likely than non-Hispanics to have difficulty accessing and using care, the report found.
“The Affordable Care Act has definitely made an impact and the numbers show it,” said Maria Gomez, president and CEO of Mary’s Center, a federally qualified health center in Washington, D.C., that serves individuals and families, regardless of their ability to pay.
However, Gomez cited a litany of continuing barriers to care, including a shortage of bilingual and culturally competent providers of care and a dearth of patient education to assure that people take medicines as prescribed.
Another expert agreed that increased access to health insurance alone isn’t enough.
“Expanding insurance is a positive move, but that alone is not going to make the major difference that we are all looking for,” said Dr. Luis Marcos, CEO of the Physician Affiliate Group of New York, the largest multicultural and multilingual physician practice in New York State.
The CDC report was based on final data from the 2013 and 2014 National Health Interview Survey, a survey of U.S. adults aged 18 to 64.
Uninsured rates for all Americans—black, white, Asian and Hispanic—fell in 2014, the report found.
“The drop that we see between 2013 and 2014 is the largest drop we’ve seen in a while for uninsured for these populations,” said report author Michael Martinez, a statistician with the CDC’s National Center for Health Statistics.
White and Asian adults showed gains in coverage, but they were also the least likely to be uninsured. Just 11.5 percent and 12 percent, respectively, lacked coverage in 2014.
Martinez said expanded access to health insurance through the federal and state marketplaces and some states’ expansion of Medicaid—key features of the Affordable Care Act, also called Obamacare—”are probably contributing” to the decline in the ranks of the uninsured.
Coverage expansions under the Affordable Care Act took full effect in 2014, although some states began expanding Medicaid much earlier.
Overall, slightly more than 16 percent of Americans aged 18 to 64 were uninsured in 2014, down from just over 20 percent in 2013, according to a CDC report released last month.
In addition to gains in insurance coverage, the new CDC report tracked changes in three other measures of health access.
For example, adults were asked whether they have a usual place to go for medical care. On that measure, Hispanics and whites realized significant year-over-year improvements.
“We could confidently say that that was an increase” not due to chance, said Brian Ward, report co-author and a statistician at the NCHS.
By contrast, there was no significant change in blacks’ and Asians’ access to a usual place to receive medical care, the study authors found.
Cost of care also remained a barrier for many minority groups. The survey found no significant improvements in the percentages of blacks and Asians skipping needed care due to cost. Blacks were most likely not to get needed care, according to the 2014 data.
“Health care cost is really the major variable in understanding access to care in this country,” Marcos said. Removing cost as a barrier to seeking care “will be the final and most difficult goal to achieve.”