ACA Healthcare Coverage Gains Chip Away at Racial and Ethnic Disparities

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By Guest Contributor |

by Cindy Pearson

Racial and ethnic disparities in health coverage and access to health care are shrinking as a result of the Affordable Care Act (ACA), according to several recent studies. The latest report, from the U.S. Department of Health and Human Services (HHS), flags a key measure of improvement – whether women had to delay or skip care because of cost concerns – before and after the ACA was implemented:

  • The proportion of Black women reporting they had to delay or skip care because of cost concerns fell from 18.6 percent in 2010 to 15.1 percent in 2014, a drop of 3.5 percentage points.
  • Among Latinas, the rate of those who had to delay or forgo care fell from 17 percent to 12.9 percent, a drop of 4.1 percentage points.
  • The rate also fell among white women from 13.7 percent to 11.6 percent, a drop of 2.1 percentage points, and among Asian/Pacific Islander women, from 6.8 percent to 5.5 percent, a decline of 1.3 percentage points.

So, racial and ethnic disparities still existed by 2014, but were somewhat less pronounced, according to this report, “Promoting Better Health Care for Women.”

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A report issued earlier this year by HHS demonstrated similar reductions in racial disparities in health insurance coverage between 2010, when the ACA was signed into law, and 2016:

  • The uninsured rate among Blacks declined 11.8 percentage points from 22.4% to 10.6%.
  •  The uninsured rate among Latinos declined 11.3 percentage points from 41.8% to 30.5%.
  •  Among Whites, the uninsured rate declined by 7.3 percentage points from 14.3 to 7.0.

The Guttmacher Institute published a paper earlier this year that estimated total coverage among women of reproductive age, including marketplace plans; Medicaid expansion and women covered by private insurance. The researchers surveyed women in 2012 and again in 2015. Overall, the proportion of women who didn’t have coverage declined from 19% to 12%. Here is how the uninsured rates differed among racial and ethnic groups:

  • Among Black women surveyed, the un-insurance rate dropped from dropped from 22% to 12%.
  • The un-insurance rate among Latinas also dropped, from 37% to 29%. That is still a disproportionately high rate. Moreover, there were pronounced differences between those Latinas born in the U.S. (whose un-insurance rate declined from 26.2 percent to 19.4 percent) and those who were foreign born (down only slightly from 47.3 percent to 44.2 percent).
  • Among White women, the un-insurance rate fell from 12.8 percent to just 6.3 percent.

While we know that millions of Latinas have benefited from the ACA, we also know some of the reasons that their coverage gains lag behind: the provisions of the ACA that prohibit undocumented immigrants from using their own funds to purchase coverage through the marketplace, and the continued refusal of 19 states to accept federal funds to close the coverage gap and expand Medicaid. You can count on Raising Women’s Voices and its network of regional coordinators to continue advocating for all states to Cover Our Families and close the coverage gap. All women deserve coverage and high quality health care!

Cindy Pearson is the executive director of the National Women’s Health Network and the co-founder of Raising Women’s Voices.

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