Report: Affordable Care Act Narrowed Disparities in Health Care Access

The Commonwealth Fund recently released a report, How the Affordable Care Act Has Narrowed Racial and Ethnic Disparities in Access to Health Care. The Report found significant coverage gains nationwide as a result of the Affordable Care Act (ACA), with historic reductions in racial disparities in coverage and access.

Some key findings from the report:

• Coverage expansions from the Affordable Care Act (ACA) led to nationwide improvements in coverage and access to care.
• The ACA also led to historic reductions in racial disparities in coverage and access since 2014. This is true across most states, and especially those that have expanded Medicaid. However substantial gaps between people of color and whites remain across all regions and income levels.
• According to the U.S. Census Bureau’s American Community Survey, the U.S. working-age adult uninsured rate fell from 20.4 percent in 2013, just before the law’s main provisions took effect, to 12.4 percent in 2018.This improvement occurred between 2013 and 2016; since then, the rate has risen slightly.
• The uninsured rate for black adults dropped from 24.4 percent in 2013 to 14.4 percent in 2018.
• The rate for Hispanic adults decreased from 40.2 percent in 2013 to 24.9 percent in 2018.

Unfortunately, the report also noted that progress in coverage expansion for all three groups has slowed since 2016, and insurance coverage has slightly eroded for both black and white adults. According to the report:

“That can be linked in part to congressional inaction: there has been no federal legislation since 2010 to enhance or reinforce the ACA. At the same time, recent legislation and executive actions have negatively affected Americans’ coverage and access to care, including: the repeal of the individual mandate penalty for not having health insurance; substantial reductions in funding for outreach and enrollment assistance for people who may be eligible for marketplace or Medicaid coverage; and the loosening of restrictions on health plans that don’t comply with the ACA’s rules.”