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.
A Denver Health team is pairing patients with bilingual therapists for culturally sensitive telephone counseling and the director of Finding Answers discusses a roadmap for ending health disparities.