Differential Rates of Medicaid Uptake for Hispanic English Speakers and Hispanic Spanish Speakers under the Affordable Care Act

One provision of the Affordable Care Act was Medicaid expansion, which increased eligibility in two ways: it raised the income threshold from 100 to 138% of the poverty line, and removed categorical restrictions, such as being a pregnant woman, to include all low-income adults. We capitalize on this policy change to determine if eligible Hispanics and Spanish speakers are more or less likely than their non-Hispanic and English-speaking counterparts to enroll in Medicaid. We use National Health Interview Survey data and apply a theoretical framework of social capital acquisition. We find that Hispanic Spanish speakers and Hispanic English speakers are about twice as likely to have Medicaid after the ACA expansion. However, Spanish speakers are about 75% as likely to have enrolled in Medicaid than their English-speaking counterparts post-ACA. In the NHIS sample, about 28% of Hispanic Spanish speakers have Medicaid. We see considerable evidence that Hispanics who have more social capital are much more likely to enroll in Medicaid. Even though the ACA expansion reduced the uninsured gap for Hispanics, there is still a noteworthy disparity in rates of insurance coverage.