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After 10 Years of Obamacare, Racial Gaps in Coverage Persist: Study

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WEDNESDAY, March 4, 2020 (HealthDay News) -- Obamacare narrowed racial and ethnic gaps in access to health insurance and care, but it didn't eliminate them, a new study reports.

University of Michigan researchers analyzed data gathered from 19- to 64-year-olds nationwide between 2008 and 2017. They found that before Affordable Care Act (ACA) insurance programs went into effect in 2010, nearly 25% of blacks and 40% of Hispanics in this age group didn't have health insurance, compared with 15% of whites.

Between 2013 and 2017, however, the insurance gap between blacks and whites narrowed 45%, and that between Hispanics and whites narrowed 35%.

In states that expanded Medicaid, the insurance gap between whites and blacks closed completely when population differences were taken into account, researchers said.

By 2017, however, more than 27 million Americans in the age group studied still lacked health insurance, including 14% of blacks, 25% of Hispanics and 8.5% of whites.

"This is a glass half-full, glass half-empty story," said study co-author Thomas Buchmueller, a professor of business economics and public policy.

As health coverage improved, fewer said they had gone without health care because they couldn't afford it, with gaps among blacks, Hispanics and whites narrowing, but remaining by 2017, the Michigan health economists found.

"The half-full aspect is that coverage increased and disparities declined, and those with the greatest need tended to benefit," Buchmueller said in a Michigan news release. "But we still have large disparities, particularly for Hispanic non-citizens. And lack of insurance means lower access to care and poorer health outcomes."

The study also found that racial/ethnic disparities changed at roughly the same rate whether states did or did not expand Medicaid.

"Medicaid expansion made a big difference for low-income Americans in the states that chose to opt in, but it did so for all racial and ethnic groups, so it did not make a significant difference in how much the gap between whites and blacks or Hispanics closed," said study co-author Helen Levy. She's a research professor at Michigan's Institute for Social Research.

The study findings appear in the March issue of the journal Health Affairs. The research is scheduled to be presented March 10 at a 10-year ACA anniversary event in Washington, D.C., organized by the journal.

More information

The U.S. National Library of Medicine has more on health insurance.

SOURCE: University of Michigan, news release, Feb. 28, 2020

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