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Health News
Black Families Gain Most from Medicaid Expansion
By Freddie Allen
NNPA Senior Washington Correspondent
WASHINGTON (NNPA) – As families prepare to choose
health insurance coverage during the open enrollment peri-
od, a recent report by the Urban Institute shows that Blacks
have the most to gain from the Patient Protection and
Affordable Care Act (ACA) if the states they live in expand
Medicaid under the law.
The Urban Institute, a nonprofit research group focused
on social and economic policy, estimated that Blacks will
experience, “the largest decreases in uninsurance rates
under full Medicaid expansion: a drop from 11.3 percent
(projected with current expansion decisions) to 7.2 percent”
and the uninsurance rate gap between Blacks and Whites
will fall from 6.5 percent under current Medicaid expansion
to 2.6 percent with full expansion.
However, the gap between Black and White uninsurance
rates will remain closer to 7 percent, at least for the near
future, because most Blacks live in states that have refused
to expand Medicaid under the ACA.
The original law, passed in 2010, mandated Medicaid
expansion nationwide, but the United States Supreme Court
2012 decision in the National Federation of Independent
Business v. Sebelius case reversed that provision, leaving it
to the states to decide whether they want to take additional
Medicaid funding under the ACA.
According to the Urban Institute, “As of December 2014,
27 states and the District of Columbia had expanded Medi-
caid or planned to expand by January 2015.”
President Obama signing the Patient Protection and
Affordable Care Act on March 23, 2010.
Care Act become harder for governors and state legislators
to dismiss.
In December, Republican Tennessee Gov. Bill Haslam
moved to expand Medicaid under the ACA, leaving less
than two dozen states to weigh providing health care for
their poorest residents against future costs associated with
Medicaid.
The Urban Institute report on uninsurance rates under the
ACA said that improving health literacy, translation servic-
es, outreach through ethnic media and working with trusted
members of the community can also aid in driving down the
levels of uninsured.
According to a recent report by the Department of Health
and Human Services (HHS), 87 percent of the people who
selected health insurance plans through HealthCare.gov
were eligible for financial assistance, a 7 percent increase
over last year’s numbers.
“That includes more than 3.4 million people who selected
a plan in the 37 states that are using the HealthCare.gov
platform for 2015, and more than 600,000 consumers who
selected plans in the 14 states that are operating their own
Marketplace platform for 2015,” stated a press release on
the report.
A more detailed view of enrollment data collected from
November 15 to December 26 showed that roughly 6.5 mil-
lion people either selected plans or were automatically
reenrolled.
The uninsurance rate for Blacks
would fall from 19.6 percent to
11.3 percent
The Urban Institute projected that Blacks would comprise
12.8 percent of all coverage gains under current Medicaid
expansion policies and 2.9 million Blacks would get health
insurance. The uninsurance rate for Blacks would fall from
19.6 percent to 11.3 percent.
More than half of all Blacks live in states, primarily in the
South and led by Republican governors, that didn’t expand
Medicaid after the ACA was passed in 2010.
When states refused to expand Medicaid, the move
trapped Blacks in a “coverage gap,” because many of them
don’t meet the income-based requirements to qualify for
Medicaid under their own state rules or to receive subsidies
through the ACA marketplace.
About 1.4 million Blacks fall into this category, account-
ing for more than 23 percent of the uninsured non-elderly
adult Blacks. For example, in Florida, Georgia, Texas and
North Carolina, the uninsured rates for Blacks would plum-
met roughly 30 percent compared to current rates, if those
states expanded Medicaid coverage under the ACA.
“For blacks, however, the difference between their unin-
surance rates and whites’ rates is projected to narrow under
the ACA with current Medicaid expansion decisions only in
Medicaid expansion states,” the report said. “Across all
states, the difference in uninsurance rates between blacks
and whites is projected to stay approximately the same both
under the ACA with current Medicaid expansion decisions
and without the ACA.”
In August 2014, researchers with the Urban Institute said
that 6.7 million residents would still remain uninsured in
2016 in the states that continued to block Medicaid expan-
sion through the ACA.
“These states are foregoing $423.6 billion in federal Med-
icaid funds from 2013 to 2022, which will lessen economic
activity and job growth,” the August 2014 report said.
“Hospitals in these 24 states are also slated to lose a $167.8
billion (31 percent) boost in Medicaid funding that was
originally intended to offset major cuts to their Medicare
and Medicaid reimbursement.”
The report continued: “For every $1 a state invests in
Medicaid expansion, $13.41 in federal funds will flow into
the state.”
The Council of Economic Advisers (CEA), a small group
that offers the president domestic and foreign economic
advice, predicted that, Medicaid expansion would have
added, in nonexpanding states, nearly 79,000 jobs in 2014,
“172,400 jobs in 2015, and 98,200 jobs in 2016.”
The August 2014 report also noted that that the rate of
uninsured in the states that expanded Medicaid fell by near-
ly 40 percent, since September 2013, the number of
uninsured in the non-expansion states fell by less than 10
percent.
The technical difficulties that plagued the rollout of
HealthCare.gov last year have faded from headlines, and
the benefits of Medicaid expansion under the Affordable
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