Consistent Enrollment in a Health Care Coverage Program Is Associated With Fewer Type 2 Diabetes-Related Emergency Department Visits for Uninsured Immigrants

BACKGROUND: Undocumented immigrants face significant barriers maintaining regular health care, which could lead to emergency department (ED) visits for chronic diseases such as type 2 diabetes (T2D). Local health coverage programs like MyHealthLA (MHLA) in Los Angeles County can improve disease management by providing regular access to care. This study examines the relationship between enrollment patterns in MHLA and ED utilization for T2D-related conditions, focusing on how the duration of enrollment impacts the likelihood of ED visits. RESEARCH DESIGN: We analyzed 115,690 ED encounters from 44,333 MHLA patients in the Los Angeles Department of Health Service (LADHS) between 2016 and 2020. There were 5 categories based on enrollment 12 months before the ED encounter: (1) continuously enrolled ≥6 months, (2) newly enrolled for <6 months, (3) consistently unenrolled for ≥6 months, (4) newly unenrolled <6 months, and (5) never enrolled, who visited the ED before ever enrolling in MHLA. RESULTS: Patients continuously enrolled in MHLA were less likely to visit the ED for short-term T2D complications, suggesting that consistent primary care helps manage chronic conditions and reduce ED use. Conversely, patients newly enrolled or unenrolled had higher odds of T2D-related ED visits, indicating that enrollment lapses may worsen disease management. CONCLUSIONS: These findings highlight the importance of continuous access to primary care and the potential benefits of Medicaid expansion for undocumented adults in California. Health systems should prioritize continuity of care to improve chronic disease management and reduce avoidable ED visits in underserved populations.