Recent changes to Medicaid programs, aimed toward closing a health coverage gap within the U.S., have left behind some Americans — particularly people of color.
Among the many non-elderly population within the U.S. — those under age 65 — insured rates rose throughout the Covid pandemic, with 3.4 million Americans enrolling in health coverage between 2019 and 2022, in keeping with a report by KFF. That shift was due partially to the Medicaid and health care marketplace provisions put in place in consequence of the Reasonably priced Care Act, the report said.
But as the worldwide health crisis waned and Medicaid coverage expansions faced delays in some states, insured rates fell and Black Americans remained disproportionately uninsured compared with white Americans, in keeping with KFF, formerly often called Kaiser Permanente.
In 2022, 10% of Black Americans were uninsured, compared with 6.6% of white Americans. Black people were 1.5 times more prone to be uninsured than their white peers in 2022, the report said. Individuals who identified as American Indian or Alaskan Native were 2.9 times more likely than their white counterparts to be uninsured, while Hispanic Americans were 2.7 times more prone to be uninsured.
“The largest driver of the racial coverage gap is the states which have not expanded Medicaid under the Reasonably priced Care Act,” said Jenn Wagner, a director on the Center on Budget and Policy Priorities. “Those states have the next population of Black individuals who’re unable to access Medicaid coverage because they do not fit into one among the eligibility categories inside that state.”
Medicaid, a joint program between the federal government and states, offers medical insurance to low-income adults and kids. The Reasonably priced Care Act passed in 2010, included a provision to expand Medicaid coverage to people at lower income levels who might not be covered by private insurers. But not all states have expanded the coverage requirements, in keeping with KFF.
In those states that have not expanded Medicaid, uninsured adults who don’t meet the necessities for coverage but still fall under the poverty line are left with little option.
In 2022, about half of Black Americans younger than 65 were insured through an employer or a personal insurer, in keeping with KFF, while nearly 40% were insured through Medicaid or one other public option.
Black unemployment rates are consistently higher than the national average and better than other groups, in keeping with U.S. Bureau of Labor Statistics data, meaning fewer Black people have access to medical insurance through employers. In January, Black unemployment ticked up barely to five.3%, in keeping with the bureau, compared with a national average of three.7% and a white unemployment rate of three.4%.
“Most Black individuals are in a family with a full-time employee, but less likely than their white counterparts to have private coverage, which reflects that they are more prone to be in low-income jobs that will not offer health coverage,” said Samantha Artiga, a director at KFF.
In states that do not offer Medicaid expansion, 13.3% of non-elderly Black Americans are uninsured, in keeping with KFF, compared with 7.3% of that population in states which have already adopted the expansion.
Adding to the disparity in uninsured rates, a separate provision of Medicaid that mechanically reenrolled participants for coverage led to March 2023, leaving thousands and thousands of Americans to proactively reenroll themselves. Many, unaware of the changes, saw their coverage lapse.
“We’re seeing loads of administrative barriers with the renewal process which are coming very clear,” Wagner said. “Individuals are losing coverage, not because they’re determined ineligible or fall into the coverage gap, but because they didn’t get the shape or the state didn’t process the timeline.”
Since March, at the least 17.4 million people were disenrolled from Medicaid or the related Kid’s Health Insurance Program coverage. Greater than 35 million people had their coverage renewed, while 41 million renewals are either pending or not yet due, in keeping with KFF.
Community health centers reminiscent of West Oakland Health, founded by 4 Black women in 1967, are working to deal with the coverage gap. Robert Phillips, the chief executive officer of WOH, said the middle noticed a downtick in patients immediately following the tip of continuous enrollment.
“The drop in Medicaid patients was precipitous,” Phillips said.
Phillips and his staff began reaching out to their Medicaid patients, and he said patients have been returning because the centers alert them to the necessity to renew their coverage.
“It’s making us work extra hard,” Phillips said. “We wish folks to know they’re still eligible for coverage and for many who just didn’t know because they got a notice saying that their coverage ended.”
WOH’s five locations within the East Bay Area of California serve minorities and low-income households in search of inexpensive health care. Many of the patients at WOH are Black and are covered under Medicaid, in keeping with the corporate.
