Racial disparities in health care insurance coverage and access to care decreased among Black and Latino patients, according to a report released Thursday by The Commonwealth Fund.
The group, a D.C.-based nonprofit that studies and research health care topics, used data dating from 2013, three years after the Affordable Care Act went into effect in 2010. Since 2013, racial disparities for uninsured white adults compared to uninsured Black adults stood at nearly 10 percentage points. By 2018, it decreased to 5.8 percentage points.
During the same time frame, the Latino disparity with whites stood at almost 26 percentage points in 2013 and reduced to 16 percentage points in 2018.
The decrease in racial disparities of those ages 19 to 64 is also partly due to jurisdictions such as California, Maryland and the District of Columbia expanding Medicaid eligibility.
“What is striking to the degree to which those differences have narrowed in coverage and access to health care,” said Sara Collins, vice president of Commonwealth Fund. “It’s important to note that we’ll continue to see those kinds of improvements as more states expand Medicaid, or if there is a federal solution to the Medicaid coverage gap that we’re hearing about in the campaign so far from Democrat [presidential candidates].”
Collins said one problem is that about four million people still remain uninsured, especially in larger states such as Texas and Florida that still haven’t expanded Medicaid.
The report shows that 31 states and the District of Columbia expanded Medicaid by Jan. 1, 2018. Within the 19 states that didn’t, about 46 percent of adult Blacks and 36 percent of Latinos remained uninsured.
The report also shows progress has stalled since 2016 with one reason being congressional action, especially with President Donald Trump and Republicans choosing to strip some ACA benefits such as reducing the individual mandate that allowed people to have insurance and lower premiums.
Collins said another reason for the decline in health care coverage is the dearth of federal funding for outreach and enrollment. In addition, undocumented immigrants aren’t eligible for subsidized coverage or Medicaid.
A federal court ruled last month that making all Americans carry health insurance is unconstitutional, but Democratic presidential candidates continue to push for the ACA to return to its original status. Sen. Bernie Sanders (I-Vermont) wants to incorporate a Medicare for All plan.
With federal inaction and uncertainty about the future of health care, state officials are taking over, said Del. Joseline Peña-Melnyk (D-District 21) of College Park.
She said about 750,000 Marylanders didn’t have insurance coverage prior to the Affordable Care Act’s passage in 2010. Today, the number has been cut by more than half.
According to the Commonwealth Fund report, the uninsured rate among Blacks in Maryland decreased from about 15 percent in 2013 to about 9 percent in 2018. For Latinos, it decreased from 41 percent to 30 percent.
Peña-Melnyk said the state could see a bigger decrease in health disparities with the work of the Prescription Drug Affordable Board, which held its first meeting Monday and is the first group in the nation created to assess and provide recommendations on how to make drugs more affordable.
She acknowledged racial gaps still exist for the uninsured. In addition, problems remain for minority patients who experience unconscious bias among doctors and health care providers who don’t accept Medicaid.
“The states are now the ones taking up these policies because the federal government is not doing it, especially since this president has been in office,” she said. “Racial gaps still exist. Your zip code should not determine your health, but things have improved. We see that the Affordable Care Act works.”