Report: Extending insurance coverage could reduce longstanding racial disparities in health care

By NC Policy Watch

The extension of health insurance under the Affordable Care Act will likely help reduce longstanding differences in health and health care by race, a new report finds.

Racial disparities in health outcomes and access to health care have persisted for many years in North Carolina, with inconsistent or little improvement under the current health care system, according to a new report by the Budget and Tax Center, a project of the North Carolina Justice Center. Under the Affordable Care Act, long-standing racial and ethnic differentials in health insurance coverage are poised to shrink due to the expansion of insurance coverage to hundreds of thousands of individuals and families, particularly through the Medicaid expansion.

“North Carolina must implement the Medicaid expansion responsibly and effectively in order to reduce racial health disparities and reap the benefits of improved health outcomes and resulting cost savings,” said Brenna Burch, a policy analyst with the Budget and Tax Center and author of the report.

A greater share of people of color are uninsured than whites, and this lack of insurance is one reason for the continued disparities in access to health care in communities of color, the report finds. In North Carolina, 71.7 percent of African Americans under the age of 65 reported they had some health insurance, compared to 82.9 percent of whites. In addition, Latinos and American Indians in North Carolina are more likely than whites or African Americans to be uninsured, and have been unable to visit a doctor due to cost.

Uninsured people are less likely to receive medical care, the report points out, and a lack of both insurance and access to care for minorities in North Carolina contributes to poorer health outcomes in communities of color, as measured by mortality rates, infant mortality rates, and the prevalence of common and preventable diseases such as diabetes and stroke. African Americans are three times more likely to die from heart disease compared to whites, and on average, minorities with heart failure are younger than whites with the same condition, the report finds.

Because health insurance is so important to accessing health care and improving health outcomes, the expansion of Medicaid under the Affordable Care Act promises to improve the health of North Carolina’s minority communities and reduce long-standing racial health care disparities by extending coverage to traditionally underserved communities throughout the state. However, the policy will only succeed if the state is able to enact effective outreach to enroll thousands of eligible adults and children.

"The success of the expansion -- and its potential as a long-term cost savings measure -- is dependent on large-scale participation," Burch said. "The social and economic benefits of a healthier population are indisputable, and as such, policymakers should seize this opportunity to do right by communities of color and implement the Medicaid expansion in an effective and timely manner in 2014."

You can find the full report at this link.