Medicaid Eligibility Expansion Regardless of Immigration Status and Insurance Coverage Among Latinos Seen in Community Health Centers, 2018–2023

Objectives. To assess whether Latino patients receiving care in community-based health centers (CHCs) in US states that expanded Medicaid eligibility regardless of immigration status to adults 50 years and older had greater insurance coverage after the eligibility amendment compared with states that did not expand eligibility. Methods. We performed a retrospective cohort study, using electronic health record data from 40 602 nonpregnant CHC patients aged 50 to 64 years living in states that expanded eligibility (OR, CA) or that did not (AK, CT, IN, MN, MT, NC, NJ, OH, WA) with a visit in both 2018–2019 (before policy change) and 2021–2023 (after policy change). Results. Among Spanish-preferring Latinas, the overall Medicaid-insured difference-in-difference estimate across all 3 years after the amendment was positively moderate (average treatment effect on treated [ATT] 5 17.04; 95% confidence interval [CI] 5 0.10, 13.98); however, this effect was greatest in the third year after the amendment (ATT 5 121.82; 95% CI 5 14.04, 29.59), and this was accompanied by a substantial drop in third year uninsured visit rates (ATT 5 215.45; 95% CI 5 224.77, –6.13). We observed the same pattern for Spanish-preferring Latinos. Conclusions. The findings suggest that expanding Medicaid eligibility regardless of immigration status improved access to health insurance for some Latino communities..