Table 3.

DIFFERENCE-IN-DIFFERENCE AND DIFFERENCE-IN- DIFFERENCE-IN-DIFFERENCES ESTIMATES OF HEALTH INSURANCE AND HEALTHCARE VISITS AMONG A POPULATION OF PATIENTS WITH DIABETES, 2013–2015^a

	Non- Expansion Post- vs pre- ACA between racial/ethnic group	Expansion Post- vs pre- ACA between racial/ethnic group	Expansion vs. Non- Expansion Postvs pre- ACA between racial/ethnic group
Medicaid-insured	DDb (95% CI)	DDb (95% CI)	DDDc (95% CI)
Non-Hispanic white	ref	ref	ref
Hispanic	1.06 (0.94, 1.19)	1.17 (1.01, 1.35)*	1.10 (0.91, 1.33)
Non-Hispanic black	1.05 (0.94, 1.17)	0.88 (0.74, 1.05)	0.83 (0.68, 1.02)
Uninsured
Non-Hispanic white	ref	Ref	ref
Hispanic	1.05 (0.94, 1.17)	1.94 (1.41, 2.66)*	1.84 (1.32, 2.58)*
Non-Hispanic black	0.97 (0.81, 1.15)	1.10 (0.79, 1.54)	1.14 (0.78, 1.67)
Privately-insured
Non-Hispanic white	ref	ref	Ref
Hispanic	1.53 (1.03, 2.28)*	1.14 (0.89, 1.46)	0.74 (0.46, 1.19)
Non-Hispanic black	0.96 (0.79, 1.17)	1.16 (0.89, 1.50)	1.20 (0.87, 1.67)
Total Visits
Non-Hispanic white	ref	ref	Ref
Hispanic	1.09 (1.00, 1.18)	1.09 (0.97, 1.24)	1.01 (0.87, 1.17)
Non-Hispanic black	0.98 (0.89, 1.07)	0.92 (0.82, 1.02)	0.94 (0.81, 1.08)
New Patient
Non-Hispanic white	ref	ref	ref
Hispanic	1.09 (0.92, 1.29)	1.14 (0.98, 1.33)	1.05 (0.83, 1.32)
Non-Hispanic black	1.02 (0.88, 1.18)	0.82 (0.68, 1.00)	0.81 (0.63, 1.04)
Established Patient
Non-Hispanic white	ref	ref	ref
Hispanic	1.07 (0.99, 1.16)	1.11 (0.97, 1.26)	1.03 (0.89, 1.20)
Non-Hispanic black	0.99 (0.91, 1.09)	0.89 (0.80, 0.99)*	0.90 (0.78, 1.03)
Preventive Service Visit
Non-Hispanic white	ref	ref	ref
Hispanic	1.12 (0.87, 1.45)	1.07 (0.92, 1.23)	0.95 (0.71, 1.27)
Non-Hispanic black	1.04 (0.82, 1.31)	1.07 (0.78, 1.48)	1.04 (0.70, 1.54)

Notes

^aModels were adjusted for CHC patient population demograpics [i.e., clinic-level distribution of sex, age, FPL, and Charlson Comorbidity Index score as of 12/31/2018 (% of non-Hispanic whites with a score ≥6, % of Hispanics with a score ≥6, % of non-Hispanic blacks with a score ≥6,)], and state-level factors including state marketplace type,⁽²¹⁾ 2014 minimum wage⁽²²⁾ and unemployment rate,⁽²³⁾ and 2013 uninsured rate.⁽²⁴⁾

^bDD estimates of post vs. pre rate ratios between race/ethnic groups stratified by expansion status.

^cDDD estimates of post vs. pre rate ratios between race/ethnic groups comparing expansion versus non-expansion.

^*Statistically significant p<.05.

ACA=Affordable Care Act Medicaid expansion

DD=Difference-in-difference

DDD=Difference-in-difference in difference

Data source: ADVANCE CDRN