Affordable Care Act lessened coverage gaps for racial groups, data shows
Racial and ethnic minority groups have been among the biggest beneficiaries of the ACA, and specifically of expanded Medicaid eligibility.
Photo: FG Trade/Getty Images
Since it passed in 2010, the Affordable Care Act has reduced the uninsured rate in the U.S. by nearly half, and one of the biggest trends to occur during this time is the narrowing of coverage gaps for racial and ethnic minority groups, especially in states that expanded their Medicaid programs as part of the law.
That's according to the Commonwealth Fund, which published data showing that more than 5 million people gained coverage between 2020 and early 2022 alone, driving the uninsured rate down to a historic low of 8%.
That recent progress, according to the Commonwealth Fund, has been driven primarily by federal and state policies that increased Medicaid and ACA marketplace coverage – especially a requirement in the Families First Coronavirus Response Act of 2020 that keeps people with Medicaid coverage continuously enrolled during the COVID-19 public health emergency in exchange for greater federal funding.
Additional states also expanded their Medicaid program eligibility, which, along with enhanced marketplace premium subsidies, also helped to reduce coverage disparities.
Racial and ethnic minority groups have been among the biggest beneficiaries of this change.
WHAT'S THE IMPACT?
Insurance coverage rates improved for Black, Hispanic, and white adults between 2013 and 2021. The coverage gap between Black and white adults dropped from 9.9 to 5.3 percentage points, while the gap between Hispanic and white adults dropped from 25.7 to 16.3 points, the data showed.
Uninsured rates for adults in all three groups improved during the first two years of the COVID-19 pandemic, a finding that held true in states that had expanded Medicaid and those that had not. Black and Hispanic adults experienced larger gains in Medicaid and individual-market coverage than white adults between 2019 and 2021.
Between 2013 and 2021, states that expanded Medicaid eligibility had higher rates of insurance coverage and healthcare access, with smaller disparities between racial/ethnic groups and larger improvements than states that didn't expand Medicaid.
In fact, after Virginia expanded Medicaid in 2019, its uninsured rate for lower-income adults dropped substantially in comparison to neighboring North Carolina, a non-expansion state, and the disparities between Black and white adults narrowed.
Yet compared to lower-income white adults, larger percentages of lower-income Black adults and lower-income Hispanic adults live in states that haven't expanded Medicaid.
THE LARGER TREND
Last year, the American Hospital Association cited data showing that racial health inequities are associated with substantial annual economic losses nationally, including at least $10 billion in illness-related lost productivity and $200 billion in premature deaths.
According to the organization, eliminating health inequities also can lead to improved patient engagement in their care process and better health outcomes; decreased readmissions; and improved performance in value-based contracts through better care management, among other improvements.
Health equity has been an ongoing focus of the Biden Administration. At the HIMSS22 annual conference in Orlando, Florida, government officials stressed the importance of interoperability in helping to achieve equitable outcomes.
Data exchange is needed to understand gaps in the system, said Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
