For treatment of substance use disorder, much research has focused on differences between Whites and African Americans in service access and use, but little has addressed disparities for Latinos, the fastest-growing population in the United States.

Scant attention has been given to Mexican Americans, the largest population of uninsured individuals and most critically underserved ethnic minority group in the United States. Given limited resources, Mexican Americans with substance-use disorder are more likely to seek treatment from publicly funded programs.

为了更好地了解墨西哥裔美国人治疗药物使用障碍的潜在差异，我们在加利福尼亚州洛杉矶县的100多个公共资助计划中分析了药物使用障碍治疗系统的数据。

We found [Medicaid payment acceptance] to be the program characteristic most associated with successful treatment for Mexican American clients.

We compared data on non-Latino White and Mexican American patients from 2010, before the Affordable Care Act (ACA) and its Medicaid expansion was implemented, and 2013, after enactment of the ACA. We compared patients on demographics, drug use severity and mental health issues, and program characteristics, including acceptance of Medicaid payments.

Our three hypotheses were supported:

1. 墨西哥裔美国人报告的治疗完成率低于非拉丁裔白人（13.3％比14.4％）。与非拉丁裔白人相比，墨西哥裔美国人的成功治疗几率明显降低。
2. 治疗方面的差异是由程序和个体特征的差异驱动的。关于个人特征，我们发现与使用海洛因的墨西哥裔美国人接受甲基苯丙胺，大麻或大麻的治疗更有可能成功地完成治疗。我们还发现，调整在计划摄入量的药物摄入量减少的墨西哥裔美国人的差异降低，尽管我们提出的并不是所有的因素都很重要。
3. Program acceptance of Medicaid payment significantly reduced treatment disparities for Mexican Americans compared to non-Latino whites.

医疗补助在减少差异中的作用

Our research is, to our knowledge, the first effort to explore provider acceptance of Medicaid as a contributor to Latino treatment disparities. Not only did we find Medicaid payment acceptance reduced disparities, we found it to be the program characteristic most associated with successful treatment for Mexican American clients.

This suggests that these programs—which must undergo a licensing and regulatory process to receive such payments—were especially successful in helping Mexican Americans overcome barriers to successful treatment as Medicaid was expanding in California.

Tru下将会出现什么问题mp administration considering these findings?

Given current debates regarding the principles of achieving universal health care and enhancing access to affordable and quality care, future research should explore how revised Medicaid coverage or other health insurance policies may affect the significant progress made in recent years in increasing health insurance coverage, as well as resulting access to specific programs such as those for substance use disorder.

In California, a new waiver program to be implemented this year (July) will support these goals regardless of potential federal changes. It will be critical for researchers to continue tracking progress in programs for the most vulnerable low-income and severely uninsured populations in California to inform national policy on improving health care for all.