Thanks to the Affordable Care Act, the American uninsured rate took the largest plummet we’ve seen in over 40 years — 16.4 million have gained coverage since Obamacare’s passage, resulting in a 35 percent drop in the number of Americans who lack insurance coverage. African Americans, in particular, have seen major gains in coverage, according to new data from the Department of Health and Human Services.
It’s been five years since Obamacare was signed to law and so far, HHS says, minorities have benefited the most from the Affordable Care Act. Latinos, who traditionally have been least likely to have health coverage, have seen the largest drop in their uninsured rate, according to the HHS report. The Latino uninsured rate fell 12.3 percentage points, from 41.8 percent to 29.5 percent. The uninsured rate for African Americans fell by nearly half, from 22.4 percent to 13.2 percent. For whites, the uninsured rate dropped by 5.3 percentage points, from a baseline of 14.3 percent.
Overall, as a result of the Affordable Care Act, 16.4 million previously uninsured Americans now have health insurance. Included among the newly-insured are 14.1 million adults who obtained health insurance since October of 2013, plus another 2.3 million young adults who gained health coverage through their parents’ plans between 2010 and October of 2013.
But the enrollment statistics don’t tell the whole story, said HHS Secretary Sylvia Burwell. “These numbers represent real people whose lives have changed for the better,” she said. Indeed, a closer look at the data reveals more about these gains, particularly their impact on racial inequalities in health care. For instance, thanks to the Affordable Care Act:
- 7.8 million African Americans with private insurance now have access to expanded preventive services with no cost-sharing. This includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.
- Over 390,000 African American women in the individual market alone have gained maternity coverage thanks to the Affordable Care Act.
- More than 500,000 African American young adults between ages 19 and 26 who would have been uninsured now have coverage under their parents’ employer-sponsored or individually purchased health insurance plan.
- About 10.4 million African Americans no longer have lifetime or annual limits on their health insurance coverage thanks to the Affordable Care Act.
- Nearly eight million African Americans with a preexisting health condition are no longer at risk of being denied coverage since the ACA prohibits insurers from denying someone coverage or charging them more because of a pre-existing condition.
“When it comes to the key metrics of affordability, access, and quality, the evidence shows that the Affordable Care Act is working, and families, businesses and taxpayers are better off as a result,” said Burwell.
Failure to expand Medicaid, upcoming SCOTUS case could halt progress
Still, more could be done to address our nation’s long-standing racial disparities in health and access to health care. Although the ACA includes many important provisions to reduce those racial disparities, the refusal of some states to accept the law’s optional Medicaid expansion has set back this progress significantly and will continue to do so until states reverse course.
Currently, about 2.5 million persons of color fall into the coverage gap in the 22 Republican-led states that haven’t expanded Medicaid. These are individuals who aren’t eligible for their states’ current Medicaid programs, but are below the income level required to qualify for subsidies to purchase private insurance on the exchanges. Poor uninsured Black adults in the South are particularly affected by the resistance to Medicaid expansion.
According to a 2014 HHS study, six out of 10 uninsured African Americans are currently eligible for Medicaid, the Children’s Health Program (CHIP) or financial assistance to purchase private coverage through the Health Insurance Marketplace. But, if all states took advantage of new opportunities to expand Medicaid coverage under the law, 95 percent of uninsured African Americans would be eligible for Medicaid, CHIP or financial assistance to buy Marketplace coverage.
Eliminating racial disparities in insurance coverage is crucial: evidence shows that health insurance can improve financial security and save lives. Moreover, reducing racial disparities would also lead to fewer unnecessary costs and inefficiencies. According to a 2009 study from George Washington University, “eliminating health disparities for minorities would have reduced direct medical care expenditures by $229.4 billion for the years 2003-2006.”
It’s important to point out that all of these observed and potential gains could be reversed by an upcoming Supreme Court ruling in a case known as King v. Burwell, which alleges that the Affordable Care Act’s tax credit subsidies are only available in the 13 states (plus the District of Columbia) that operate their own health insurance exchange marketplaces. The case is seen by most as a hyper-partisan attempt to gut the healthcare law, and the implications could be disastrous.
The federal government set up the exchanges in 34 states, so millions of residents would lose their subsidies if the high court rules for the plaintiffs. “If the court rules against the administration, customers in two-thirds of the states would be cut off from subsidies, which would create a crisis for both Congress and the White House,” the Washington Times wrote. The Rand Corp. estimates this would result in 9.6 million people becoming uninsured as their health insurance becomes too expensive and the markets in those states destabilize.