The Role of Language in Health Care Access and Utilization for Insured Hispanic Adults

Appendix Table A: Demographic Characteristics, Health Needs, and Health Coverage Among Nonelderly Insured Hispanic Adults by Language
English Spanish
Income
≤138% FPL 29% 56%*
138% – 400% FPL 45% 42%
>400% FPL 26%
Work Status
Worker in the Family 77% 73%
Full Time Worker in the Family 68% 64%
Part Time Worker in the Family 9% 9%
No Worker in the Family 23% 27%
Gender
Female 53% 60%
Male 47% 40%
Age
19 – 25 25%
26 – 34 20% 17%
35 – 44 25% 35%*
45 – 64 30% 40%*
Family Status
Married with Dependent Children 32% 34%
Married without Dependent Children 17% 16%
Not Married with Dependent Children 17% 19%
Not Married without Dependent Children 33% 31%
Health Needs
Has Ongoing Health Condition 30% 40%*
Taking Prescription Drugs 39% 43%
Type of Health Coverage
Private 72% 57%*
Medicaid 17% 29%*
Other 11% 15%
NOTE: English group includes Hispanics who completed the survey in English; Spanish group includes Hispanics who completed the survey in Spanish and indicated that they do not speak English well.

* Indicates statistically significant difference from English-speakers at p<0.05 level.

SOURCE: 2014 Kaiser Survey of Low-Income Americans and the ACA.

Appendix Table B: Experiences with and Understanding of Health Plans Among Nonelderly Insured Hispanic Adults by Language
English Spanish
Choosing a Health Plan
Somewhat/Very Difficult to Compare Services 24% 20%
Somewhat/Very Difficult to Compare Costs 20% 28%
Somewhat/Very Difficult to Compare Providers 22% 13%*
Any Problem 36% 37%
Reasons for Choosing Health Plan
Low Costs 24% 30%
Provider Selection 24% 22%
Benefits Covered 31% 19%*
Family or Friends Recommended
Other Family Also Covered 7%
Rating Health Plans
Excellent/Good Rating 89% 77%*
Not so good/Poor 9% 19%*
Understanding Health Plans
Understood Services Very/Somewhat Well 80% 54%*
Understood Out of Pocket Costs Very/Somewhat Well 83% 59%*
Gaps In Plan
Needs Services Not Covered 16% 27%*
Problems with Health Plan
Plan Did Not Pay for Services Thought Covered 19% 28%*
Plan Did Not Pay because Had Not Met Deductible 26% 19%
Out of Pocket Costs Higher than Expected 25% 22%
Difficulty Getting Question Answered 14% 17%
Difficulty Renewing Coverage 8% 15%
NOTE: English group includes Hispanics who completed the survey in English; Spanish group includes Hispanics who completed the survey in Spanish and indicated that they do not speak English well.

* Indicates statistically significant difference from English-speakers at p<0.05 level.

SOURCE: 2014 Kaiser Survey of Low-Income Americans and the ACA.

Appendix Table C: Access to Care, Utilization of Care, and Communication with Health Care Providers Among Nonelderly Insured Hispanic Nonelderly Adults by Language
English Spanish
Usual Source of Care (USOC)
Has a USOC that is not the Emergency Department 75% 72%
USOC is a:
Clinic 27% 62%*
Doctor’s Office 59% 31%*
Some Other Place 14% 7%*
Reasons for Choosing USOC:
Convenient 38% 38%
Only Place Available 6% 11%
Preferred Doctor’s Practice 34% 22%*
Good Reputation 14% 18%
Other (Affordable, Don’t Know, and Refused) 8% 11%
Has Regular Doctor at USOC 64% 62%
Utilization of Care
Postponed or Went Without Care 29% 34%
Never Ended Up Getting Needed Care 16% 10%
Used any Medical Services 75% 79%
Had Checkup or Preventive Care Visit 57% 59%
Visited Doctor’s Office or Clinic for a Specific Health Problem 54% 45%
Communication with Health Care Providers
Always/Most of the Time Got All of the Information Wanted From Doctor 87% 82%
Always/Most of the Time Felt Encouraged to Ask Questions 82% 82%
Always/Most of the Time Understood Test Results 84% 92%*
Always/Most of the Time Understood How to Take Prescribed Medication 90% 88%
NOTE: English group includes Hispanics who completed the survey in English; Spanish group includes Hispanics who completed the survey in Spanish and indicated that they do not speak English well.

* Indicates statistically significant difference from English-speakers at p<0.05 level.

SOURCE: 2014 Kaiser Survey of Low-Income Americans and the ACA.

Appendix Table D: Affordability of Health Care Costs and Financial Security Among Nonelderly Insured Hispanic Adults by Language
English Spanish
Affordability of Health Care Costs
Confident can Afford Usual Medical Costs 80% 39%*
Not Confident can Afford Usual Medical Costs 19% 60%*
Confident can Afford Major Medical Costs 60% 20%*
Not Confident can Afford Major Medical Costs 38% 79%
Worry Over Health Care Costs has Major Effect on Job, Family, or Sleep 9% 34%*
Paying Premium Very/Somewhat Difficult (Among those Paying a Premium) 26 48%*
Did Not Have Premium 35% 52%*
Medical Bill Outcomes
Has Outstanding Medical Bills 18% 17%
Any Problem Paying Medical Bills 11% 17%
Problem with Medical Bills Led to Using Up Savings 6% 9%
Problem with Medical Bills Led to Difficulty Paying for Basic Necessities 5% 8%
Problem with Medical Bills Led Borrowing Money 3%
Problem with Medical Bills Led to Being Sent to Collections 5%
Medical Bills Caused Financial Strain 8% 15%
Financial Security
Financially Insecure 24% 43% *
Somewhat/Very Difficult to Pay for Necessities 31% 62% *
Somewhat/Very Difficult to Save Money 55% 76% *
Somewhat/Very Difficult to Pay off Debt 43% 59% *
NOTE: English group includes Hispanics who completed the survey in English; Spanish group includes Hispanics who completed the survey in Spanish and indicated that they do not speak English well.

* Indicates statistically significant difference from English-speakers at p<0.05 level.

SOURCE: 2014 Kaiser Survey of Low-Income Americans and the ACA.

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