ACA reduced racial, ethnic coverage disparities, with Medicaid expansion states faring the best: report

A new report finds that racial and ethnic disparities in insurance coverage were reduced thanks to the ACA. (Getty/designer491)

The Affordable Care Act reduced racial and ethnic disparities in insurance coverage and states that expanded Medicaid saw the biggest declines, according to a new analysis.

The analysis released Wednesday from the think tank Commonwealth Fund found that uninsured rates for all racial and ethnic groups and incomes fell from 2013 to 2016 but inched up again in 2017.  

Overall the proportion of nonelderly uninsured adults declined from 20.6% in 2013 to 12.3% in 2017, a 40% decrease, according to Commonwealth.


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The coverage gap between blacks and whites declined from 11 percentage points in 2013 to 5.3 percentage points in 2017. The gap between Hispanics and non-Hispanic whites also declined to 16.6 percentage points in 2017, a decrease from 25.4 percentage points in 2013.

“Gains in coverage for all groups were greatest between 2013 and 2015 and continued, though at a lower rate, in 2016,” the analysis said. “These gains ended in 2017.”

The Commonwealth Fund said states that expanded Medicaid narrowed racial coverage gaps more than states that did not. For instance, the percentage of uninsured Hispanics declined by 6.9 percentage points from 2013 to 2017 in states that didn’t expand Medicaid. The percentage declined by 18.7 points over the same time period in states that did expand.

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As of Aug. 1, there were 14 states that chose to not adopt the ACA’s Medicaid Expansion, according to the Kaiser Family Foundation.

Voters in another three states— daho, Utah and Nebraska—passed ballot measures last year to adopt the expansion but it has not been implemented yet. The Commonwealth Fund used data from the U.S. Census Bureau’s American Community Survey to determine coverage.

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