New Study Unveils Complex Impacts of Policy Change on Healthcare Access and Inequality in Hawaii

A recent research paper titled “Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality” sheds light on the complex consequences of a 2015 policy change affecting Pacific Islander immigrants in Hawaii. The policy, which replaced Medicaid with subsidized private health insurance, triggered varying effects on healthcare utilization among different risk groups. Using a comprehensive dataset of hospitalizations and emergency room visits, the study’s findings reveal exacerbated health inequality, with high-risk individuals experiencing larger reductions in total healthcare use and increased uninsured visits. This research provides crucial insights into the impact of policy changes on healthcare access and disparities.


Akee, Randall Q., Timothy J. Halliday, and Teresa Molina. “Replacing Medicaid with an Imperfect Substitute: Implications for Health Inequality.” RSF: The Russell Sage Foundation Journal of the Social Sciences 9.4 (2023): 61-83.

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