The Real Deal: ACA and the Underserved – Panel Discussion at the National Association of Black Journalists
Keon L. Gilbert, DrPH, MA, MPA, is an assistant professor in the Department of Behavioral Science & Health Education at St. Louis University's College for Public Health and Social Justice. As a Robert Wood Johnson Foundation New Connections grantee, his research focuses on the social and economic conditions structuring disparities in the health of African American males.
The Real Deal of the Affordable Care Act (ACA) is that many Americans have many questions regarding how the ACA will affect their health care coverage or if they will be covered at all. Our panel discussion at the National Association of Black Journalists (NABJ) convention revealed many of these questions concerning how Americans will be enrolled, how their existing health insurance plans will change, and what means tests will be used to determine their eligibility. This panel discussion suggested that many Americans were not aware of what the changes will be and if their state will expand Medicaid.
Medicaid expansion will not occur in many states where close to six of ten African Americans reside. This suggests that many African Americans will remain without health insurance or will be under-insured. This is a real challenge to improving health care outcomes and reducing health care costs over time.
Our enlightening panel discussion suggests that several initiatives and questions should be more publicly discussed:
- How will the ACA alter existing health care plans?
- How will the ACA enroll Americans?
- What are the states not expanding Medicaid and what will that mean for health care plans, those who are without health care coverage, and those who are under-insured?
- Where can Americans obtain information about the ACA, not just online but within their communities in multiple formats such as print, community forums, and town hall meetings?
- Do providers know enough about the ACA and how it will influence how they practice medicine?
- Do providers know enough about the ACA to effectively communicate with their patients?
- How will the quality of care change as a result of the ACA?
It is evident that these questions, among others, are central to the successful implementation and evaluation of the ACA.
The unanswered challenges and questions about the ACA will have a great impact on underserved groups. My greatest interest is how the ACA will affect health care, especially use of preventative services by African American men. With mass improvement in the ability to access health care services, we will need to focus on reaching these men to enroll them, engaging them in processes to take advantage of the health care benefits and, for those men who will remain un-insured and under-insured, to find alternative options to access and utilize health care services. There needs to be greater focus on the preventative services men will have as a result of the ACA.
Lastly, more attention and messaging can be developed to improve health behaviors to help prevent or delay the onset of chronic disease.