The Affordable Care Act’s Coverage Expansions Will Reduce Differences In Uninsurance Rates By Race And Ethnicity

Abstract

There are large differences in US health insurance coverage by racial and ethnic groups, yet there have been no estimates to date on how implementation of the Affordable Care Act will affect the distribution of coverage by race and ethnicity. We used a microsimulation model to show that racial and ethnic differentials in coverage could be greatly reduced, potentially cutting the eight-percentage-point black-white differential in uninsurance rates by more than half and the nineteen-percentage-point Hispanic-white differential by just under one-quarter. However, blacks and Hispanics are still projected to remain more likely to be uninsured than whites. Achieving low uninsurance under the Affordable Care Act will depend on effective state policies to attain high enrollment in Medicaid and the Children's Health Insurance Program and the new insurance exchanges. Coverage gains among Hispanics will probably depend on adoption of strategies that address language and related barriers to enrollment and retention in California and Texas, where almost half of Hispanics live. If uninsurance is reduced to the extent projected in this analysis, sizable reductions in long-standing racial and ethnic differentials in access to health care and health status are likely to follow.

Health care, immigrants, and minorities: lessons from the affordable care act in the U.S.

“…Evidence of improvement in coverage was especially impressive for poor Americans and ethnoracial minorities such as African Americans and Asian Americans (Adams 2015;NASEM 2015). The gains in coverage among Latinos, who were poised to benefit significantly from the law given their high uninsurance rates, are still being contested (Clemens-Cope et al 2012). Some studies show they experienced greater gains than other ethnoracial groups (KFF 2016b) while other studies show them lagging behind (NASEM 2015).…”

Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

“…One official described this major challenge of "finding individuals, keeping them enrolled, getting them into coverage, and then into the care at the right places." Looking forward to 2014, the ability of states to achieve high enrollment rates, particularly among minorities, will be critical to efforts to reduce longstanding racial and ethnic disparities in care (Clemans-Cope, Kenney, Buettgens, Carroll, & Blavin, 2012). Several officials said that culturally-and linguisticallycompetent outreach conducted through community-based providers was one important means of overcoming these challenges.…”

‘Double Jeopardy’ Measure Suggests Blacks And Hispanics Face More Severe Disparities Than Previously Indicated

“…Research suggests that the Affordable Care Act will likely reduce racial and ethnic disparities in insurance coverage, 41 but this reduction may occur in a variety of ways. Suppose, for example, that the act narrows racial and ethnic differences in insurance coverage but only among young people.…”