Healthcare disparities persist despite ACA

A signpost with the words Affordable Care Act

Despite room for improvement in the healthcare system at large, the Affordable Care Act has strengthened Americans’ access to providers, a new literature review finds.

Researchers examined more than 100 studies dating to 2010 in a paper published in Health Services Research. Although healthcare reform has significantly enhanced access to healthcare, disparities remain across geographic regions, race, ethnicity and income.

Michael T. French, a healthcare management and policy researcher, led the study in a cooperative effort between the University of Miami and Florida Atlantic University. French examined the ACA, Medicaid expansion, participation and competition on exchanges, use of marketplace subsidies, dependent coverage provision and general health insurance coverage, access and affordability.

Among the findings:

  • 25 percent more insurers entered the ACA marketplace for 2015 open enrollment than in the previous year.
  • Low-income black Americans are disproportionately impacted by the "coverage gap," earning too much to qualify for Medicaid but not enough to be eligible for marketplace subsidies. The total population impacted by the gap is estimated at 3.7 million.
  • Greater coverage from the ACA for approximately 24 million people has improved access to doctors among all income groups.
  •  1–3 million individuals under the age of 26 received coverage as a result of the ACA, primarily for men, unmarried individuals and non-students.
  • People who still lack healthcare coverage are more apt to be low-income, young and Hispanic.

Anthem announced plans earlier this month for an initiative to engage healthcare disparities in black communities. The Centers for Medicare & Medicaid Services developed a mapping tool earlier this year as part of efforts to increase exposure to healthcare disparities. And FierceHealthcare previously reported that diversifying hospital workforces could reduce racial disparities in healthcare.