The Affordable Care Act is one specific thing that attempts to reform the health care system by doing a great number of things. At the most fundamental level, it is about increasing insurance coverage. It goes about this by expanding the Medicaid program, providing subsidies to individuals to help them purchase insurance, requiring everyone to have coverage, prohibiting insurance companies from denying people coverage, and allowing young adults to remain on their parents’ insurance until age 26. The most notable thing that it does not do, is provide coverage to undocumented immigrants.
Using microsimulation techniques–a fancy term for a fancy computer model that allows researchers to make assumptions and see the simulated results–a team at the Urban Institute, led by Lisa Clemans-Cope, Genevieve Kenney, and Matthew Buettgens, found that the Affordable Care Act will reduce racial disparities in insurance coverage. Their findings are reported in the May issue ofHealth Affairs.
Specifically, of the nearly 269 million Americans who are under age 65 and therefore mostly ineligible for Medicare, 13.9% of whites are uninsured, compared to 21.6% of blacks, 33.3% of Hispanics, and 18.5% of Asians and others (combined). When the ACA is fully-implemented, the percentage of each group that is uninsured will drop significantly, and the decrease will be larger among racial minority groups than among whites, narrowing the gap between these groups. The team at the Urban Institute reports that, in the wake of the ACA, 6.5% of whites will remain uninsured, compared to 9.8% of blacks, 21.1% of Hispanics, and 10.4% of Asians and others (combined). That means the black-white gap will narrow by 4.4 percentage points, the Hispanic-white gap will narrow by 4.8 percentage points, and the Asian/other-white gap will narrow by 0.8 percentage points.
To the extent that insurance coverage translates to access to health care, and access to health care translates to better health outcomes, it would appear, based on these results, that the insurance coverage provisions of the Affordable Care Act have the potential to significantly reduce racial disparties in health. And that’s good news.