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Why Disparities for Health Coverage Declined during COVID-19

April 03, 2023

During the COVID-19 pandemic, uninsured rates reached record lows for Black, Hispanic, and white adults and coverage disparities narrowed considerably, according to a new report from the Commonwealth Fund.

The report evaluates disparities in health coverage since the passage of the Affordable Care Act and tracks more recent trends stemming from pandemic-era policies that kept more people enrolled via individual marketplace plans, Medicaid, and the Children’s Health Insurance Program.

“While the largest coverage gains occurred from 2013 to 2016, adult uninsured rates for these three groups, and for the nation overall, dropped again between 2019 and 2021, as new federal policies aimed at boosting coverage took effect,” the report notes.

Here’s what you need to know:

  • Coverage gains:  From 2013 and 2021, uninsured rates fell 15.7 percentage points for Hispanic adults; 10.9 points for Black adults; and 6.3 points for white adults.
  • Medicaid expansion:  States that expanded Medicaid as outlined in the Affordable Care Act had lower uninsured rates and smaller disparities when compared with states that didn’t expand Medicaid coverage.
    • About 34 percent of Hispanic adults and 18 percent of Black adults during 2021 were uninsured in states that didn’t expand Medicaid. About 19 percent of Hispanic adults and 9 percent of Black adults were uninsured in expansion states.
  • Driving force:  COVID-19- era policies that expanded tax credits for state and federal health insurance marketplaces and continuous enrollment in the Medicaid program contributed to significant coverage gains in recent years.
  • Uncertain future:  Continuous enrollment in Medicaid ended March 31, meaning states will resume eligibility determinations for coverage. The expanded Affordable Care Act tax credits expire after 2025.
  • Quotable:  “If we want to continue making progress toward a more equitable health system, it’s critical to ensure that all people are continuously covered, not just during a pandemic,” said Sara R. Collins, Commonwealth Fund vice president, health care coverage and access and tracking health system performance.

With the end of continuous enrollment, the Pennsylvania Department of Human Services has developed resources to help providers share important information with patients. The toolkit includes printable education materials, scripts for conversations with patients, and digital assets, such as social media posts and website graphics.

The toolkit is available online.

If you need help with the Medicaid renewal process, assistance is available online or by calling (866) 550-4355 or (215) 560-7226 for Philadelphia residents.