1. FINAL PROJECT: MEDICAID AND RACE Meg Gilheney

2. Research Question  What race really enrolls in Medicaid the most? Does it depend on their state? Are the stereotypes that assume that African Americans and Hispanics/Latinos are using Medicaid the most correct?

3. Literature Review  African Americans are usually overrepresented in Medicaid data. 68% of African Americans receive Medicaid. Whites receive 6% (Kronenfeld 772).  Because of demographic shifts in the United States, it is predicted that by 2030 that 40% of the U.S. population will be a part of an ethnic or racial minority group. It is more imperative than ever to look at the racial disparities in health care (Weech- Maldonado 790).  Recently, the Supreme Court decision to make Medicaid optional by state is widening the racial inequality in insurance coverage. 80% of the coverage gap is in the South, which is home to the majority of the nation’s African Americans (Andrews 132).  The public opinion to the Medicaid expansion is generally favorable. Even in the states that said no to expansion. However out of those states that said no, most were Republican (Flint 69).  Republicans opposed the Affordable Care Act from the start and the majority in the House voted over 30 times to repeal it (Flint 3).

4. Works Cited (APA)  Andrews, C. (2014, August). Unintended Consequences: Medicaid Expansion and Racial Inequality in Access o Health Insurance. Health & Social Work. pp. 131-133. doi:10.1093/hsw/hlu024.  Flint, S. S. (2013, February). Health Coverage for America: Signed, Sealed, and Delivered by the 2012 Election. Health & Social Work. pp. 3-5. doi:10.1093/ hsw/hls062.  Flint, S. S. (2014, May). Who Loses When a State Declines the Medicaid Expansion?. Health & Social Work. pp. 69-72.  Kronenfeld, J. J. (1978). The Medicaid Program and a Regular Source of of Care. American Journal Of Public Health, 68(8), 771-773.  Weech-Maldonado, R., Morales, L. S., Elliott, M., Spritzer, K., Marshall, G., & Hays, R. D. (n.d). Race/Ethnicity, Language, and Patients' Assessments of Care in Medicaid Managed Care. Health Services Research, 38(3), 789-808. doi:10.1111/1475-6773.00147.

5. Data Sources Used  Centers for Medicare & Medicaid Services. (2007). Medicaid Analytic eXtract (MAX) Chartbooks (2002) Retrieved from http://www.cms.gov/Research- Statistics-Data-and-Systems/Computer-Data-and-Systems/ MedicaidDataSourcesGenInfo/Max_Chartbooks.html.  Centers for Medicare & Medicaid Services. (2008). Medicaid Analytic eXtract (MAX) Chartbooks (2004) Retrieved from from http://www.cms.gov/ Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/ MedicaidDataSourcesGenInfo/Max_Chartbooks.html.  Centers for Medicare & Medicaid Services. (2012). Medicaid Analytic eXtract (MAX) Chartbooks (2008) Retrieved from from http://www.cms.gov/ Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/ MedicaidDataSourcesGenInfo/Max_Chartbooks.html

6. Data Analysis  1. Copy and paste the data from the website  2. Click on column A  go to Data  then text to columns  delimitate by space  3. Clean up the rest of the chart  4. Insert  line chart  right click within the chart  select data  add series  highlight the title of the column first  then highlight the entire column  5. Edit axis labels  highlight the state column  click ok

7. Data Analysis  6. I made a chart for each set of data separately. I made 3 charts that included all the races and ethnicities listed.  7. Following the same directions I made 3 charts that included only the largest categories. Black, White, and Hispanic or Latino.

8. Findings In this chart, one can see that in many of the states, it is the white population that has the highest enrollment in Medicaid. One can also see in the U.S. as a whole, that whites have the highest enrollment percentage.

9. Findings In this chart from 2004, the rates of enrollment for each of the three races has stayed relatively the same for the U.S. as a whole. Most of the states have stayed the same as well. Meaning that white enrollment has stayed higher than both African Americans and Hispanics.

10. Findings In 2008, there was an increase in the Medicaid enrollment of Hispanics/Latinos in the country overall. The enrollment of Hispanics/Latinos was higher than that of African Americans, but still well below the white enrollment.