UMD study shows that Affordable Care Act has reduced racial/ethnic health disparities

African Americans and Latinos have benefitted most from access to health insurance.

The Affordable Care Act (ACA) has significantly improved insurance coverage and use of health care for African Americans and Latinos, according to a new study led by researchers in the University of Maryland School of Public Health.

"Since the ACA took effect in 2014, the rates of uninsured African Americans and Latinos were reduced by 7%, as compared to 3% for whites," explains Dr. Jie Chen, assistant professor in the Department of Health Services Administration at Maryland. "We also found that these groups were more likely to visit a primary care doctor and receive timely health care than before the ACA coverage began."

In the new report, published in the journal Medical Care, researchers analyzed data from the 2011-2014 National Health Interview Survey, which asked questions about health care access and utilization among various groups of US adults (18-64 years of age), including non-Latino whites, Latinos, African Americans and other racial and ethnic groups. The data suggest that the Affordable Care Act is playing an important role in reducing racial and ethnic health disparities. While all groups benefitted from the health insurance options made available under the ACA, racial and ethnic minorities have historically encountered greater disparities in coverage and access, and therefore have seen greater gains since the ACA went into effect.

African Americans have likely improved more on these measures under the ACA compared with whites because they are more likely to gain insurance coverage through the Health Insurance Marketplace and Medicaid expansion that has occurred under the ACA. Dr. Chen explains the relatively smaller declines in uninsured rates among Latinos by the fact that recent Latino immigrants are more likely to live in states that are not participating in the Medicaid expansion, as well as inadequate outreach to the Latino community regarding ACA eligibility, subsidies and enrollment.

"While Latinos made smaller gains than African Americans in rates of insured, those who were eligible for health coverage were significantly less likely to delay or forgo health care, which is an important factor in improving health outcomes," says Dr. Chen.

The study findings suggest that the ACA has the potential to continue the trend of reducing disparities in access to health care and health care utilization. Future research could examine changes in health care quality and health outcomes related to the Affordable Care Act to further explore its potential in reducing and eliminating racial and ethnic health disparities.