Over the last 14 years, the Affordable Care Act (ACA) has helped tens of millions of Americans gain access to affordable health coverage. Thanks to President Biden’s efforts to lower the cost of health care, a record-breaking 21.3 million Americans signed up for coverage through the Marketplaces for 2024. The Inflation Reduction Act lowered premiums for people who buy their own coverage by an average of $2,400 a year per family.
The ACA has survived countless repeal attempts and now it’s stronger than ever. Yet Republicans still want to destroy the ACA and all of its protections for over 100 million people with pre-existing conditions. Donald Trump has fully reignited his calls to repeal the ACA. As Trump is escalating his threat, Republicans in Congress and their allies are working overtime to dismantle reproductive care and access to vital preventive care, hike premiums, slash Medicare and Medicaid, reverse recent coverage gains, and raise prescription drug costs for the American people.
This week, Protect Our Care is highlighting five key ways the ACA is working across the nation:
Monday, March 18: How the ACA helps women
Tuesday, March 19: How the ACA helps seniors & young people
Wednesday, March 20: How the ACA helps people with pre-existing conditions
Thursday, March 21: How the ACA helps people of color
Friday, March 22: How the ACA expanded affordable coverage to tens of millions of Americans
Background:
There is overwhelming evidence that the ACA has made a historic contribution to improving health care for communities of color. In addition to increasing coverage and improving health outcomes, the health care law has helped narrow racial disparities in maternal health, cancer care, and more. Even as the ACA is more popular than ever, Republicans are still trying to repeal and sabotage the health care law. Meanwhile, Democrats continue their work to lower costs and expand affordable coverage. Democrats’ policies to lower costs are an essential step in reducing ethnic and racial inequities in health care, as research shows better access to care as well as a more diverse health care workforce – two goals advanced by the ACA – improve health outcomes.
By the Numbers:
- The uninsured rate among nonelderly Black and Hispanic/Latino young adults between 2010 and 2022 was cut in half from 19.9 percent to 10 percent and 32.6 percent to 18 percent respectively.
- American Indians and Alaskan Natives saw both private and public health insurance enrollment increase by 1.2 percent and 3.2 percent respectively after the implementation of the ACA with an additional 6.3 percent increase in public insurance enrollment in Medicaid expansion states.
- Medicaid expansion has reduced racial disparities in timely treatment with one study showing its introduction in states completely erases disparities in timely cancer care.
- Although less directly researched, the ACA has also empirically benefited first-generation immigrants with one study showing post-ACA that the rates of insurance increase for Latino and Asian immigrants by 14.3 percent and 9.9 percent respectively in just the state of California.
- Black and Hispanic individuals are 59.2 percent more likely to have gained health coverage due directly to the expanded premium subsidies than White individuals in non-expansion states.
Lowering the Uninsured Rate. Before the passage of the ACA, more than 16 percent of the nearly 50 million Americans lacking health insurance were African Americans. According to the Kaiser Family Foundation, the ACA helped lower the uninsured rate for nonelderly African Americans by nearly half between 2010 and 2022 from 19.9 percent to 10 percent. The percentage of people gaining health insurance under the ACA was higher for Latinos than for any other racial or ethnic group in the country. According to a study from Families USA, 5.4 million Latinos would lose coverage if the health care law were overturned. Research also shows the ACA cut uninsurance rates among Asian Americans by more than half–from nearly 20 percent to just under 8 percent — eliminating coverage disparities with white Americans.
Reductions in Racial Disparities In Health Outcomes. Access to preventive care starts with access to affordable coverage. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. The ACA significantly reduced racial disparities in the share of people who went without care because of cost. Positive medical outcomes have also increased significantly with one study showing Black heart transplant recipients had a 8 percent increase in post-surgery survival after the passage of the ACA.
Improvements To Infant And Maternal Health. Whether coverage comes from Medicaid expansion or increased access to affordable coverage on the ACA Marketplace, coverage improves infant and maternal mortality outcomes. One study found that reductions in maternal mortality in expansion states were concentrated among Black mothers, “suggesting that expansion could be contributing to decreasing racial disparities in maternal mortality.” Expansion has also been tied to improving health outcomes for Black babies, significantly reducing racial disparities in low birth weight and premature birth.
Preventive Care Leads To Improvements In Disease-Specific Diagnosis And Treatment. A 2017 study called preventive care “one of the most important health care strategies to facilitate early diagnosis and treatment, improve quality of life, and prevent premature death.” Access to preventive care through Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. According to the Center for American Progress, Black women were more likely to receive care because of the ACA.