Abstract
Objective: We studied patterns in health care access between Latino and non-Latino White adults according to citizenship status before and after the American Rescue Plan Act (ARPA) of 2021 was enacted to determine whether inequities changed. Methods: This study used 2019-2022 National Health Survey Interview data. Differences in predicted probabilities from logistic regression models were used to estimate changes in health care access outcomes (any insurance coverage, private insurance coverage, delaying care due to cost, and having a usual source of care) among Latino citizens, Latino noncitizens, and non-Latino White citizens in periods before and after ARPA's enactment (2019-2020 vs 2021-2022). Results: Adjusted models observed that inequities in health care access did not change between Latino and non-Latino White citizens from the 2019-2020 period to the 2021-2022 period. Moreover, the health insurance gap widened by 5.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 5.2 percentage points between Latino noncitizens and Latino citizens (P < 0.05) from the 2019-2020 period to the 2021-2022 period. The private insurance coverage gap widened by 6.8 percentage points between Latino noncitizens and non-Latino White citizens (P < 0.01) and by 6.9 percentage points between Latino noncitizens and Latino citizens (P < 0.01) from the 2019-2020 period to the 2021-2022 period. Conclusion: ARPA may have helped increase White citizens' insurance coverage, but this benefit did not extend to Latinos, regardless of citizenship status. Developing more inclusive health policies that do not have restrictions based on citizenship and legal authorization status is an important step toward reducing health care inequities.