To assess how the Affordable Care Act (ACA) impacted changes in access and utilization of health care between groups by examining differences across groups of immigrants and by citizenship status. Data came from respondents of the 2011–2016 National Health Interview Survey aged 18 to 64 who were born outside of the U.S. or were native-born non-Latino whites (N = 119,198). Outcome measures included (all in the past 12 months): being currently uninsured, being insured via Medicaid, visiting the emergency department, visiting a doctor at least once, delaying care due to costs, not getting needed care because respondent was unable to afford it and being told by doctor office that they would not accept you as a new patient. The ACA was associated with greater healthcare access and utilization for some groups, but heterogeneously across all groups. For example, some immigrant groups had better access and utilization than others, and similar variation was revealed across citizenship groups. This study underscores the importance of disentangling how policies can affect immigrants from different regions of the world, which has implications for healthcare utilization and disparities. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Health services immigrants health policy disparities

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