Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage

Objectives. To document how health insurance coverage changed for White, Black, and Hispanic adults after the Affordable Care Act (ACA) went into effect. Methods. We used data from the American Community Survey from 2008 to 2014 to examine changes in the percentage of nonelderly adults who were unin...

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Bibliographic Details
Published in:American journal of public health (1971) Vol. 106; no. 8; pp. 1416 - 1421
Main Authors: Buchmueller, Thomas C., Levinson, Zachary M., Levy, Helen G., Wolfe, Barbara L.
Format: Journal Article
Language:English
Published: United States American Public Health Association 01.08.2016
Subjects:
Access to Care
Adult
AJPH Policy
Bankruptcy
Clinical outcomes
Continental Population Groups
Cultural differences
Economic inequality
Employers
Ethnic differences
Ethnic Groups - statistics & numerical data
Ethnicity
Female
Health care
Health care access
Health care expenditures
Health care industry
Health care policy
Health disparities
Health insurance
Health Law
Health Reform
Health services
Health Services Accessibility - statistics & numerical data
Healthcare Disparities - ethnology
Humans
Income - statistics & numerical data
Indigent care
Inequality
Insurance
Insurance coverage
Insurance Coverage - statistics & numerical data
Insurance, Health - statistics & numerical data
Male
Medicaid
Medicaid - statistics & numerical data
Medical personnel
Medically Uninsured - ethnology
Medically Uninsured - statistics & numerical data
Middle Aged
Noncitizens
Other Race/Ethnicity
Patient Protection & Affordable Care Act 2010-US
Patient Protection and Affordable Care Act
Policy making
Poverty
Public health
Race
Racial differences
Racial inequality
Risk reduction
Socioeconomic Factors
States
Subsidies
Tax credits
Uninsured people
United States
Young Adult
United States > US
ISSN:0090-0036, 1541-0048, 1541-0048
Online Access:Get full text
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Description
Summary:Objectives. To document how health insurance coverage changed for White, Black, and Hispanic adults after the Affordable Care Act (ACA) went into effect. Methods. We used data from the American Community Survey from 2008 to 2014 to examine changes in the percentage of nonelderly adults who were uninsured, covered by Medicaid, or covered by private health insurance. In addition to presenting overall trends by race/ethnicity, we stratified the analysis by income group and state Medicaid expansion status. Results. In 2013, 40.5% of Hispanics and 25.8% of Blacks were uninsured, compared with 14.8% of Whites. We found a larger gap in private insurance, which was partially offset by higher rates of public coverage among Blacks and Hispanics. After the main ACA provisions went into effect in 2014, coverage disparities declined slightly as the percentage of adults who were uninsured decreased by 7.1 percentage points for Hispanics, 5.1 percentage points for Blacks, and 3 percentage points for Whites. Coverage gains were greater in states that expanded Medicaid programs. Conclusions. The ACA has reduced racial/ethnic disparities in coverage, although substantial disparities remain. Further increases in coverage will require Medicaid expansion by more states and improved program take-up in states that have already done so.
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Peer Reviewed
CONTRIBUTORS
All authors contributed to the analysis and the writing of the article.
ISSN:0090-0036
1541-0048
1541-0048
DOI:10.2105/AJPH.2016.303155