Reform in Action: Equity in the Context of Health Reform

Insights from Aligning Forces for Quality and Finding Answers: Disparities Research for Change

A number of provisions in 2010’s Affordable Care Act (ACA) directly address the goal of reducing disparities in health and health care among minority populations. Increasing access to health coverage will have a significant effect. More than half of the 46 million people who are currently uninsured are minorities.

Starting in January 2014, all individuals living at or below 133 percent of the poverty level will be eligible for Medicaid. The law will prevent insurance companies from denying coverage to people with pre-existing conditions, a group in which minorities are over-represented. Hispanics and Blacks also tend to have lower rates of employer-sponsored coverage, making them more likely to benefit from health insurance exchanges, government-regulated marketplaces designed to enable more small businesses to offer employees health insurance.

While ACA does much to increase the likelihood that more minority patients than ever before will be covered by health insurance in the next few years, there is substantial evidence that coverage alone cannot reduce disparities in quality of care and outcomes. A comprehensive data collection provision builds collection and use of stratified race, ethnicity, language, gender, and disability data into Medicaid, CHIP, and other federally funded programs. This will identify specific disparities more accurately than in the past. Federal grants will aim to increase the number of underrepresented minorities in the health care workforce and direct funds to those who serve minority populations. The law also provides $11 billion in support for community health centers, where the majority of patients are racial and ethnic minorities.

AF4Q in Action

The Robert Wood Johnson Foundation’s Aligning Forces for Quality (AF4Q) and Finding Answers initiatives are actively studying, developing and implementing strategies to reduce racial and ethnic gaps in care. By focusing on the collection of race, ethnicity and language data, improving translation services, and sharing best practices, these projects are leading the way to reduce disparities in care.

Learn more about AF4Q

Hear from Finding Answers

Many hospitals and health care providers assume that every patient who walks through their doors receives the same quality of care. But the reality couldn't be more different. A Denver Health team led by David Brody, MD, is pairing patients with bilingual therapists for culturally sensitive telephone counseling and Marshall Chin, MD, director of Finding Answers: Disparities Research for Change, discusses a roadmap for ending health disparities.

Learn more about Finding Answers

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