Investigating how Asian Americans are getting health insurance

A new study offers detailed analysis of the relative roles of Medicaid versus private insurance in boosting rates of health insurance coverage for Asian Americans, Native Hawaiians and Pacific Islanders (AANHPI) under the Affordable Care Act (ACA).

Previous research from Harvard T.H. Chan School of Public Health found that AANHPI experienced health insurance coverage gains under the ACA, raising their coverage to levels similar to that of non-Hispanic whites in the U.S. The new research offers more detail, showing that AANHPI are the first racial/ethnic group to have insurance gains through Medicaid in Medicaid-expansion states that essentially match that of private coverage gains in non-expansion states.

In both Medicaid expansion and nonexpansion states, uninsurance rates among AANHPI dropped roughly 18 percentage points from 2010-13 to 2015-16. But while most of the coverage gains in expansion states were through Medicaid, it was the opposite in nonexpansion states, where most of the gains came through private insurance.

Although overall coverage rates for AANHPI improved regardless of whether insurance was through Medicaid or private insurance, the authors suggested that future research should look at the relative value of the two types of coverage, such as differences in out-of-pocket spending or in choice of providers.

Harvard Chan School authors of the study included senior author Howard Koh, Benjamin Sommers, and Arnold Epstein. First author was John Park, MPH ’17.

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Affordable Care Act increased health insurance coverage, narrowed disparities for Asian Americans, Native Hawaiians, Pacific Islanders (Harvard Chan School release)