Academic journal article Asian American Policy Review

Disparities in Health Insurance Coverage among Asian Americans

Academic journal article Asian American Policy Review

Disparities in Health Insurance Coverage among Asian Americans

Article excerpt

ABSTRACT | Asian Americans are the fastest-growing racial group in the United States, and yet they have some of the highest rates of being uninsured when disaggregated into ethnic subgroups. Analyzing U.S. Census data from the 2008 to 2010 American Community Surveys, this article seeks to identify factors contributing to disparities in health insurance coverage among the six largest Asian American ethnic subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese Americans. Multiple regression analysis done through IBM SPSS Statistics found that a combination of socioeconomic factors (household income, rate of self-employment, and educational attainment) as well as acculturative factors (percent native-born and percent limited English proficient) each produced statistically significant correlations with the differences in health insurance coverage observed among Asian American ethnic subgroups. Policies aimed at improving health outcomes for Asian Americans in the United States will therefore need to address both the socioeconomic and acculturation issues potentially preventing emerging Asian American ethnic groups from accessing the health care system through health insurance and the Patient Protection and Affordable Care Act.

INTRODUCTION

The passage of the U.S. Patient Protection and Affordable Care Act (ACA) in March 2010 has left a profound impact on the future of the U.S. health care system, as state and federal governments continue to implement provisions of the ACA to expand health insurance coverage and affordable access to care for millions of uninsured Americans. Along with a federal mandate for individuals to purchase health insurance by 1 January 2014, the ACA also contains additional provisions aimed at increasing health insurance rates, either by expanding public health insurance eligibility or by encouraging Americans to purchase affordable private health plans through federal subsidies and insurance reforms. Some of the ACA's major reform items include: setting uniform standards for states to expand Medicaid eligibility for those up to 133 percent of the federal poverty line; establishing state and federal health exchanges with federally subsidized health plans available for those up to 400 percent of the federal poverty line; prohibiting insurers from denying coverage based on preexisting conditions; and ensuring that young adults up to twenty-six years of age can remain covered under their parents' insurance plans.

Despite Congressional opposition to the ACA legislation and legal challenges raised by a few states, the U.S. Supreme Court decision in June 2012 to uphold the constitutionality of the ACA's individual mandate as well as the re-election of President Barack Obama in November 2012 indicate that most provisions of the ACA will remain to be implemented, significantly affecting how health insurance will be accessed by millions of Americans for the foreseeable future.

The importance of health insurance coverage in producing better health outcomes has been studied and documented extensively. In February 2009, the Institute of Medicine (IOM) released a summary report, the last of a series of seven reports spanning from 2001 to 2004, citing a number of research studies with evidence linking attainment of health insurance coverage with direct improvements in health outcomes. According to these studies, health insurance coverage was more often than not the major factor determining in whether children and adults had access to the preventive, diagnostic, and treatment health care services crucial for preventing illness, suffering, and death (Institute of Medicine of the National Academies 2009). Based on this, the IOM made strong recommendations for the United States to implement a health reform policy to achieve health insurance coverage for all Americans, arguing that continuing rising health care costs and a weakened economy would lead more people to avoid paying premiums for health insurance and exacerbate an already severe decline in health insurance coverage. …

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