Healthcare Reform; Insurance Expansion; Hispanic/Latino Health; Health Disparities


Bilingual, Multilingual, and Multicultural Education | Community Health and Preventive Medicine | Public Health | Public Health Education and Promotion


Latinos have the highest uninsurance rates of any ethnic or racial group in the US despite recent health insurance expansion reform. In addition to immigration and language barriers, health literacy and attitudes may impact coverage disparities. Focus groups with Spanish-speaking community members and semi-structured interviews with health insurance navigators were conducted to explore knowledge, awareness, and attitudes towards healthcare reform among Latinos in Rhode Island. Sessions were audio recorded, transcribed, and analyzed employing standard qualitative methods. Thirty-two focus group participants and six navigators were enrolled in the study. Spanish-speaking participants demonstrated limited knowledge of the cost implications of the Medicaid Expansion and of the role of health insurance exchanges. Common misconceptions included that insurance costs would increase regardless of income, that enrollment would compromise green card and citizenship applications, that documented non-permanent residents would be ineligible for subsidies, and that reform benefits would apply to undocumented workers. Our findings suggest that local initiatives and providers should target Latinos in a culturally sensitive manner to increase literacy regarding insurance eligibility, affordability, points of access as well as to address misconceptions related to insurance eligibility for documented immigrants.


All authors have given their permission for this submission. This study was IRB approved.