ACA Tied to Narrowing of Disparities in Access to Care

THURSDAY, Jan. 16, 2020 -- The Affordable Care Act has reduced disparities in access to health care among black, Hispanic, and white adults, according to a January data brief released by the Commonwealth Fund.

Jesse C. Baumgartner, from the Commonwealth Fund in New York City, and colleagues used data from the American Community Survey and the Behavioral Risk Factor Surveillance System (2013 to 2018) to assess the differences in the share of uninsured adults, those who went without care because of cost in the past 12 months, and those with a usual source of care.

The researchers found that during the study period, adult uninsured rates decreased for all groups, with a drop from 24.4 to 14.4 percent for black adults and from 40.2 to 24.9 percent among Hispanics. Furthermore, the gap between black and white adult uninsured rates dropped by 4.1 percentage points, while the difference between Hispanic and white uninsured rates fell 9.4 points. While these three groups had better overall access to care in expansion states versus nonexpansion states, disparities narrowed in both states that expanded Medicaid eligibility and in those that did not. However, insurance gains made by blacks and Hispanics have stalled, and even eroded, since 2016 -- much as they have for the overall population. While all groups had fewer financial barriers to accessing care, the largest reductions were seen in black and Hispanic adults. Only modest increases were noted in black and Hispanic groups with regard to having a usual source of care (an increase of approximately 3 percentage points from 2013 to 2018).

"We hope these findings will help guide policymakers as they consider options for moving the nation closer to a more equitable, higher-performing health care system," the authors write.

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Posted: January 2020