Uninsurance is not Just a Minority Issue: White Americans Are a Large Share of the Growth from 2000 to 2010

A report funded by the Robert Wood Johnson Foundation, as part of its Affordable Care Act (ACA) Implementation - Monitoring and Tracking Series, compares changes in health insurance coverage from 2000 to 2010 across racial and ethnic groups. The authors find that employer-sponsored insurance (ESI) deteriorated among all racial and ethnic groups, with whites and blacks experiencing larger percentage-point declines relative to Hispanics and the Asian/other group.

Key Findings

  • The number of uninsured increased by 12.9 million from 2000 to 2010, nearly half of whom (6.3 million) are white.

  • From 2001 to 2010 the uninsured rate increased 38 percent among whites, 21 percent among blacks, and remained constant for the Hispanic and Asian/other population.

  • Medicaid and the Children’s Health Insurance Plan (CHIP) appear to have been effective in preventing coverage declines among Hispanics and Asian/others, as enrollment gains were large enough to offset ESI declines for these groups.

The authors note that with the Supreme Court ruling, the Medicaid expansion to those with incomes below 138 percent of federal poverty level is essentially optional for states. Several states, particularly those in the South with large and racially diverse uninsured populations, have suggested that they will not implement the expansion, where more than half of individuals projected to be newly eligible for Medicaid are white.

Thus, reducing coverage gaps across racial and ethnic groups will depend on which states implement the Medicaid expansions, the size of the black and Hispanic uninsured populations within these states, and the extent to which state policies and targeted outreach efforts can achieve high rates of participation in Medicaid/CHIP and the health insurance exchanges.