Medicaid Managed Care and Resource Use among Older Hispanics in Texas

Jacqueline L. Angel, University of Texas at Austin
Henry S. Brown, University of Texas at Austin

Texas has the highest rate of uninsurance in the United States. And among the uninsured, Hispanics make up the vast majority. There is a growing literature documenting this disparity by insurance status and its effects on health outcomes. However, an important issue is that those with insurance face greater access barriers in areas with higher uninsurance rates than in those with insurance low uninsurance rates. There are two main reasons: health care professionals may avoid areas with high uninsurance and capital investment may lag. This is especially true in areas which have high numbers of immigrants because in addition to having lower uninsurance rates and hence less ability to pay, fewer providers are willing or able to work in those communities. The Patient Protection and Affordable Care Act (PPACA) offers a natural experiment to test the positive spillovers of growing insurance rates on Hispanics with Medicaid in Texas.