{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:32:45Z","timestamp":1789788765394,"version":"4.0.1"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Cancer is the leading cause of death for Latino and Latina individuals in the US. Lack of insurance is one of the leading contributing factors to low prevalence of colorectal cancer screening. In 2021, the state Medicaid coverage programs in California and Oregon were amended to expand income-based eligibility for Medicaid to adults aged 50 years or older regardless of immigration status.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether expanding Medicaid eligibility regardless of immigration status to adults aged 50 years or older with low income was associated with improvements in the prevalence of up-to-date colorectal cancer screening among Latino and Latina patients who received care at community health centers.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective case-control study used electronic health record data from clinics from January 2018 to December 2023 in states that expanded Medicaid eligibility regardless of immigration status by 2021 (California and Oregon) and from those that did not amend their eligibility (Indiana, Minnesota, Ohio, and Washington). The dataset included Latino and Latina patients aged 50 to 63 years who were uninsured at baseline and had visits both before (2018-2019) and after (2021-2023) the Medicaid eligibility amendment (excluding 2020 because of the COVID-19 pandemic and its association with primary care delivery).<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n State adoption of the 2021 Medicaid income-based eligibility amendment regardless of immigration status to adults aged 50 years or older.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The prevalence of up-to-date colorectal cancer screening was assessed using a doubly robust covariate-adjusted difference-in-differences model to estimate the average treatment effect on the treated (ATT).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were 6503 Latino and Latina patients (mean [SD] age, 54.04 [3.32] years; 3623 females [55.7%]) from 218 clinics included in the study, of whom 5957 (91.6%) preferred the Spanish language. The prevalence (in percentage points) of colorectal cancer screening increased among uninsured English-preferring Latino and Latina patients (ATT\u2009=\u200919.53 [95% CI, 9.04-30.02]), English-preferring Latino men (ATT\u2009=\u200916.72 [95% CI, 1.27-32.16]) when considering all 3 years of the posteligibility period, and Spanish-preferring Latina women (ATT\u2009=\u20098.58 [95% CI, 1.48-15.67]) in the third posteligibility year in eligibility amendment states more than their counterparts in nonamendment states.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this case-control study of Latino and Latina patients, expansion of Medicaid eligibility was associated with significantly higher prevalence of colorectal cancer screening rates among Spanish-preferring Latina women and English-preferring Latino and Latina patients. The findings suggest that state-funded coverage expansions may help increase colorectal cancer\u2013screening prevalences in this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.59100","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:30:32Z","timestamp":1770827432000},"page":"e2559100","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Colorectal Cancer Screening Among Latino Adults Following the Medicaid Eligibility Amendment Expansion"],"prefix":"10.1001","volume":"9","author":[{"given":"Nathalie","family":"Huguet","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Holderness","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Erroba","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Mertes","sequence":"additional","affiliation":[{"name":"Department of Innovation and Improvement, OCHIN, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Innovation and Improvement, OCHIN, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Marino","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Heintzman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"zoi251568r3","doi-asserted-by":"publisher","DOI":"10.1177\/15579883231179325","article-title":"Barriers and facilitators of colonoscopy screening among Latino men in a colorectal cancer screening promotion program.","author":"Mojica","year":"2023","journal-title":"Am J Mens Health"},{"issue":"5","key":"zoi251568r5","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.3390\/cells10051018","article-title":"Disparities in early-onset colorectal cancer.","volume":"10","author":"Muller","year":"2021","journal-title":"Cells"},{"issue":"3","key":"zoi251568r6","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.tige.2023.02.007","article-title":"Reducing disparities and achieving health equity in colorectal cancer screening.","volume":"25","author":"Segura","year":"2023","journal-title":"Tech Innov Gastrointest Endosc"},{"key":"zoi251568r7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.jss.2022.08.024","article-title":"Barriers to colorectal cancer screening in US immigrants: a scoping review.","volume":"282","author":"Puli","year":"2023","journal-title":"J Surg Res"},{"issue":"5","key":"zoi251568r8","doi-asserted-by":"publisher","first-page":"2981","DOI":"10.1007\/s40615-023-01756-6","article-title":"Effect of Medicaid expansion in reducing racial disparities in early onset colorectal cancer.","volume":"11","author":"Rahman","year":"2024","journal-title":"J Racial Ethn Health Disparities"},{"issue":"1","key":"zoi251568r9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1370\/afm.1741","article-title":"An early look at rates of uninsured safety net clinic visits after the Affordable Care Act.","volume":"13","author":"Angier","year":"2015","journal-title":"Ann Fam Med"},{"key":"zoi251568r10","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ypmed.2019.05.003","article-title":"Cervical and colorectal cancer screening prevalence before and after Affordable Care Act Medicaid expansion.","volume":"124","author":"Huguet","year":"2019","journal-title":"Prev Med"},{"issue":"6","key":"zoi251568r11","doi-asserted-by":"publisher","first-page":"905","DOI":"10.3122\/jabfm.2018.06.180075","article-title":"The impact of the Affordable Care Act (ACA) Medicaid expansion on visit rates for diabetes in safety net health centers.","volume":"31","author":"Huguet","year":"2018","journal-title":"J Am Board Fam Med"},{"key":"zoi251568r12","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001257","author":"Marino","year":"2020","journal-title":"Med Care"},{"issue":"9","key":"zoi251568r13","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.2337\/dc19-1571","article-title":"The Affordable Care Act: effects of insurance on diabetes biomarkers.","volume":"43","author":"Marino","year":"2020","journal-title":"Diabetes Care"},{"issue":"1","key":"zoi251568r14","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1353\/hpu.2019.0011","article-title":"Racial\/ethnic disparities in health insurance and differences in visit type for a population of patients with diabetes after Medicaid expansion.","volume":"30","author":"Angier","year":"2019","journal-title":"J Health Care Poor Underserved"},{"issue":"5","key":"zoi251568r15","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1370\/afm.2125","article-title":"Uninsured primary care visit disparities under the Affordable Care Act.","volume":"15","author":"Angier","year":"2017","journal-title":"Ann Fam Med"},{"issue":"4","key":"zoi251568r16","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1370\/afm.2385","article-title":"Following uninsured patients through Medicaid expansion: ambulatory care use and diagnosed conditions.","volume":"17","author":"Huguet","year":"2019","journal-title":"Ann Fam Med"},{"key":"zoi251568r21","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.healthplace.2018.08.023","article-title":"Who loses public health insurance when states pass restrictive omnibus immigration-related laws? the moderating role of county Latino density.","volume":"54","author":"Allen","year":"2018","journal-title":"Health Place"},{"key":"zoi251568r22","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14020","author":"Bustamante","year":"2022","journal-title":"Health Serv Res"},{"key":"zoi251568r23","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.puhe.2017.06.006","article-title":"Underlying challenges of public health insurance enrollment and use among Latino adults: insights from the largest safety-net institution in Los Angeles.","volume":"152","author":"Guerrero","year":"2017","journal-title":"Public Health"},{"key":"zoi251568r24","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.977792","article-title":"The impact of COVID-19 and access to health services in the Hispanic\/Mexican population living in the United States.","volume":"10","author":"Rangel G\u00f3mez","year":"2022","journal-title":"Front Public Health"},{"key":"zoi251568r25","doi-asserted-by":"publisher","DOI":"10.1177\/21501319241278874","article-title":"Achieving cancer equity by improving health insurance access for all Latinos.","author":"Huguet","year":"2024","journal-title":"J Prim Care Community Health"},{"issue":"6","key":"zoi251568r28","doi-asserted-by":"publisher","first-page":"900","DOI":"10.2105\/AJPH.2025.308052","article-title":"Medicaid eligibility expansion regardless of immigration status and insurance coverage among Latinos seen in community health centers, 2018\u20132023.","volume":"115","author":"Huguet","year":"2025","journal-title":"Am J Public Health"},{"issue":"4","key":"zoi251568r32","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1007\/s10903-019-00925-2","article-title":"Using electronic health record data to study Latino immigrant populations in health services research.","volume":"22","author":"Heintzman","year":"2020","journal-title":"J Immigr Minor Health"},{"issue":"3","key":"zoi251568r33","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1007\/s40615-016-0232-1","article-title":"In low-income Latino patients, post-Affordable Care Act insurance disparities may be reduced even more than broader national estimates: evidence from Oregon.","volume":"4","author":"Heintzman","year":"2017","journal-title":"J Racial Ethn Health Disparities"},{"issue":"2","key":"zoi251568r34","doi-asserted-by":"publisher","DOI":"10.1136\/fmch-2022-001972","article-title":"Answering calls for rigorous health equity research: a cross-sectional study leveraging electronic health records for data disaggregation in Latinos.","volume":"11","author":"Heintzman","year":"2023","journal-title":"Fam Med Community Health"},{"key":"zoi251568r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2023.107657","article-title":"The role of language in mammography orders among low-income Latinas over a 10-year period.","volume":"175","author":"Heintzman","year":"2023","journal-title":"Prev Med"},{"issue":"13","key":"zoi251568r36","doi-asserted-by":"publisher","first-page":"2970","DOI":"10.1007\/s11606-023-08139-x","article-title":"Statin eligibility and prescribing across racial, ethnic, and language groups over the 2013 ACC\/AHA guideline change: a retrospective cohort analysis from 2009 to 2018.","volume":"38","author":"Heintzman","year":"2023","journal-title":"J Gen Intern Med"},{"issue":"2","key":"zoi251568r37","first-page":"37","article-title":"\u201cYou can\u2019t vote, right?\u201d: when language proficiency is a proxy for citizenship in a civics classroom.","volume":"4","author":"Dabach","year":"2014","journal-title":"J Int Soc Stud"},{"issue":"2","key":"zoi251568r39","doi-asserted-by":"publisher","DOI":"10.1177\/15579883231158525","article-title":"Rural Latino men\u2019s experiences and attitudes toward health: a pilot photovoice study.","volume":"17","author":"Daniel-Ulloa","year":"2023","journal-title":"Am J Mens Health"},{"issue":"4","key":"zoi251568r40","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1136\/amiajnl-2014-002744","article-title":"The ADVANCE network: accelerating data value across a national community health center network.","volume":"21","author":"DeVoe","year":"2014","journal-title":"J Am Med Inform Assoc"},{"issue":"8","key":"zoi251568r41","first-page":"33","article-title":"Understanding when to use the new patient E\/M codes.","volume":"10","author":"Hill","year":"2003","journal-title":"Fam Pract Manag"},{"issue":"6","key":"zoi251568r42","doi-asserted-by":"publisher","first-page":"883","DOI":"10.3122\/jabfm.2019.06.190087","article-title":"Prevalence of pre-existing conditions among community health center patients before and after the Affordable Care Act.","volume":"32","author":"Huguet","year":"2019","journal-title":"J Am Board Fam Med"},{"issue":"1","key":"zoi251568r43","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1016\/j.jeconom.2020.06.003","article-title":"Doubly robust difference-in-differences estimators.","volume":"219","author":"Sant\u2019Anna","year":"2020","journal-title":"J Econom"},{"issue":"8","key":"zoi251568r44","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1097\/MLR.0000000000001879","article-title":"Delivery of cervical and colorectal cancer screenings during the pandemic in community health centers: practice changes and recovery strategies.","volume":"61","author":"Huguet","year":"2023","journal-title":"Med Care"},{"issue":"1","key":"zoi251568r45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0317057","article-title":"Effect of the COVID-19 pandemic on colorectal cancer screening in two university-affiliated health care systems.","volume":"20","author":"Kumar","year":"2025","journal-title":"PLoS One"},{"issue":"2","key":"zoi251568r48","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1177\/1043659606286767","article-title":"Health care seeking among Mexican American men.","volume":"17","author":"Sobralske","year":"2006","journal-title":"J Transcult Nurs"},{"issue":"8","key":"zoi251568r49","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1111\/j.1745-7599.2006.00144.x","article-title":"Machismo sustains health and illness beliefs of Mexican American men.","volume":"18","author":"Sobralske","year":"2006","journal-title":"J Am Acad Nurse Pract"},{"issue":"6","key":"zoi251568r50","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1370\/afm.250066","article-title":"Trends, innovations, and future care for chronic conditions in Latinos: a report from the 2024 Latino Primary Care Summit.","volume":"23","author":"Marino","year":"2025","journal-title":"Ann Fam Med"},{"key":"zoi251568r1","unstructured":"WISQARS leading causes of death visualization tool. Centers for Disease Control and Prevention. Accessed December 20, 2023. https:\/\/wisqars.cdc.gov\/lcd\/?o=LCD&y1=2023&y2=2023&ct=10&cc=ALL&g=00&s=2&r=0&ry=2&e=2&ar=lcd1age&at=groups&ag=lcd1age&a1=0&a2=199"},{"key":"zoi251568r2","unstructured":"New estimates highlight differences in growth between the U.S. Hispanic and non-Hispanic populations. US Census Bureau. June 27, 2024. Accessed July 21, 2025. https:\/\/www.census.gov\/newsroom\/press-releases\/2024\/population-estimates-characteristics.html"},{"key":"zoi251568r4","unstructured":"Cancer facts & figures for Hispanic\/Latino people 2024-2026. American Cancer Society. Accessed July 21, 2025. https:\/\/www.cancer.org\/content\/dam\/cancer-org\/research\/cancer-facts-and-statistics\/cancer-facts-and-figures-for-hispanics-and-latinos\/2024\/2024-2026-cancer-facts-and-figures-for-hispanics-and-latinos.pdf"},{"key":"zoi251568r17","unstructured":"Office of the Assistant Secretary for Planning and Evaluation. Health insurance coverage and access to care among Latinos: recent trends and key challenges. June 7, 2024. Accessed July 21, 2025. https:\/\/aspe.hhs.gov\/reports\/health-insurance-coverage-access-care-latinos"},{"key":"zoi251568r18","unstructured":"US Census Bureau. Select a dataset & vintage. American Community Survey 1-year estimates public use microdata sample. 2024. Accessed July 21, 2025. https:\/\/data.census.gov\/app\/mdat\/ACSPUMS1Y2024"},{"key":"zoi251568r19","unstructured":"Baker? B. Population estimates. Estimates of the unauthorized immigrant population residing in the United States: January 2015\u2013January 2018. US Department of Homeland Security. January 2021. Accessed December 28, 2023. https:\/\/ohss.dhs.gov\/sites\/default\/files\/2023-12\/unauthorized_immigrant_population_estimates_2015_-_2018.pdf"},{"key":"zoi251568r20","unstructured":"Key facts on health coverage of immigrants. KFF. January 15, 2025. Accessed July 21, 2025. https:\/\/www.kff.org\/racial-equity-and-health-policy\/fact-sheet\/key-facts-on-health-coverage-of-immigrants\/"},{"key":"zoi251568r26","unstructured":"Health, Committee Bill. California Assembly Bill 133. CA AB133. Session 2021-2022. LegiScan. July 27, 2021. Accessed January 6, 2026. https:\/\/legiscan.com\/CA\/text\/AB133\/id\/2426274"},{"key":"zoi251568r27","unstructured":"Oregon House Bill 3352. OR HB3352. LegiScan. September 25, 2021. Accessed January 5, 2026. https:\/\/legiscan.com\/OR\/bill\/HB3352\/20"},{"key":"zoi251568r29","unstructured":"OHP enrollment report. Oregon Health Authority. Accessed December 15, 2025. https:\/\/www.oregon.gov\/oha\/hpa\/analytics\/pages\/medicaid-enrollment.aspx"},{"key":"zoi251568r30","unstructured":"An act to provide for reconciliation pursuant to title II of H. Con. Res. 14, Pub L No. 119-21, 139 Stat. 72 (2025). Accessed January 5, 2026. https:\/\/www.congress.gov\/119\/plaws\/publ21\/PLAW-119publ21.pdf"},{"key":"zoi251568r31","unstructured":"Community Health Centers: providers, partners and employers of choice. 2024 Chartbook. National Association of Community Health Centers. Accessed August 2024. https:\/\/www.nachc.org\/wp-content\/uploads\/2024\/07\/2024-2022-UDS-DATA-Community-Health-Center-Chartbook.pdf"},{"key":"zoi251568r38","unstructured":"Schmidt? H, Waltner? AM, Muller? ST. The immigrant health initiative: a study of health care of recent immigrants in Dutchess County, New York. Dutchess County Government. February 28, 2011. Accessed July 21, 2025. https:\/\/www.dutchessny.gov\/departments\/dbch\/docs\/immigrant-health-initiative.pdf"},{"key":"zoi251568r46","unstructured":"Health and Human Services. California Health and Human Services Agency. Accessed June 26, 2025. https:\/\/ebudget.ca.gov\/2025-26\/pdf\/Revised\/BudgetSummary\/HealthandHumanServices.pdf"},{"key":"zoi251568r47","unstructured":"Budnick N. Trump administration seeks Medicaid data from Oregon amid immigration crackdown. The Lund Report. June 13, 2025. Accessed July 21, 2025. https:\/\/www.thelundreport.org\/content\/trump-administration-seeks-medicaid-data-oregon-amid-immigration-crackdown"},{"key":"zoi251568r51","unstructured":"Colorectal cancer screenings for the Hispanic community. Marion County Public Health Department. Accessed January 5, 2026. https:\/\/marionhealth.org\/englishcolorectalcancer\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2844920\/huguet_2026_oi_251568_1770231760.4949.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:30:35Z","timestamp":1770827435000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2844920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":51,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.59100","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]}}}