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Research Brief Explores ACA Impact on Racial, Ethnic Access to Care

January 16, 2020

According to an issue brief issued by the Commonwealth Fund, the Affordable Care Act (ACA) not only narrowed racial and ethnic disparities in insurance coverage, but also has reduced racial disparities in access to health care.

Researchers reviewed data from the federal American Community Survey and Behavioral Risk Factor Surveillance System to examine racial and ethnic differences since the ACA went into effect, differences between states that expanded Medicaid, and policy options to further reduce disparities.

Key findings include:

  • Coverage expansion from the ACA has led to reductions in racial disparities in access to health care since 2013, but progress has stalled and, in some cases, eroded since 2016
  • The gap between black and white adult uninsured rates dropped by 4.1 percentage points, while the difference between Hispanic and white uninsured rates fell 9.4 points
  • Disparities narrowed in both states that expanded Medicaid and in those that did not. In expansion states, blacks, Hispanics, and whites all had better overall access to care than they did in nonexpansion states
  • Five years after the ACA’s implementation, black adults living in states that expanded Medicaid report coverage rates and access to care measures as good as or better than what white adults in non-expansion states report
  • While black working-age adults have benefited significantly from Medicaid expansion, they disproportionately (46%) reside in the 15 states that haven’t yet expanded their programs

For more information about access to care issues, contact Jolene Calla, Esq, HAP’s vice president, health care finance & insurance. For more information about HAP’s work on social determinants of health, or to become involved in population health initiatives, please contact Robert Shipp, HAP’s vice president, quality and population health.