Graph of uninsured Americans, 2008-2014

Post-ACA changes in health insurance coverage for blacks, whites, Hispanics

10/20/2016 feature story

Thomas Buchmueller, Helen Levy, and colleagues find reduced racial/ethnic disparities in health insurance coverage following implementation of the Affordable Care Act, particularly in states that expanded Medicaid programs.

More Information.

Helen Levy
Thomas C. Buchmueller

Publication Information:

Buchmueller, Thomas C., Z. Levinson, Helen Levy, and B. Wolfe. 2016. "Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage." American Journal of Public Health, 106(8): 1416-1421. PMCID: PMC4940635.

We used data from the American Community Survey (2008-2014) to document how health insurance coverage changed for white, black, and Hispanic non-elderly adults after the Affordable Care Act (ACA) went into effect. We examined changes in the percentage of each group who were uninsured, covered by Medicaid, or covered by private health insurance, stratifying by income and state Medicaid expansion status. We found that 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. Although the ACA has reduced racial/ethnic disparities in coverage, substantial disparities remain. We posit that further reductions will require Medicaid expansion by more states and improved program take-up in states that have already done so.

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