Minorities & The ACA
The Affordable Care Act (ACA) will affect the health care of every American in some form as it continues to be implemented. The law's intended effects are particularly targeted on certain groups. For example, the ACA creates a new Office of Minority Health to address disease prevention, health promotion, risk reduction, healthier lifestyle choices, use of health care services and barriers to health care. Some of the largest minority groups in America include African Americans, Hispanics, American Indians, Alaska Natives, Asian Americans, Native Hawaiians and Pacific Islanders.
The problem of health disparities
Before the ACA was passed, minorities tended to suffer from what is commonly called "health disparities," which is simply one way of saying that minorities tended to suffer more from health issues than the majority population. For example, the 2010 Census Bureau report found that minorities tend to have lower infant mortality rates, and also have lower life expectancy than Whites. [1]
More specifically, look at the following 2010 statistics from the Office of Minority Health for the 43.8 million African Americans (14 percent of the overall population) living in the United States:
- 44 percent of African Americans in comparison to 62 percent of non-Hispanic Whites used employer-sponsored health insurance.
- 28 percent of African Americans in comparison to 11 percent of non-Hispanic Whites relied on Medicaid, public health insurance.
- 20.8 percent of African Americans in comparison to 11.7 percent of non-Hispanic Whites were uninsured.
- In 2009, the death rate for African Americans was higher than Whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS and homicide.
The statistics are also glaring for the 52 million Hispanics (approximately 16.7 percent of the population) who live in the United States:
- Hispanics have the lowest insured rates of any racial or ethnic group; just 39.6 percent of Mexicans are insured, 51.6 percent of Puerto Ricans, 51.6 percent of Cubans and 46.4 percent of other Hispanic and Latino groups.
- In 2010, 30.7 percent of the Hispanic population was not covered by health insurance, as compared to 11.7 percent of the non-Hispanic White population.
- Hispanics have higher rates of obesity than non-Hispanic Whites.
- The rate of low birth weight infants is lower for the total Hispanic population in comparison to non-Hispanic Whites.
- Puerto Ricans have a low birth weight rate that is 60 percent higher than the rate for non-Hispanic Whites.
- Also Puerto Ricans also suffer disproportionately from asthma, HIV/AIDS and infant mortality.
- Mexican-Americans suffer disproportionately from diabetes.
According to the Office of Minority Health, these health disparities are caused by a number of factors, with economics being one of the leading factors. For example, 26.6 percent of Hispanics, in comparison to 14.9 percent of non-Hispanic Whites, work within service occupations, and those occupations tend to not provide health benefits. The unemployment rate for African Americans was twice as high as the unemployment rate for Non-Hispanic Whites, according to the 2010 Census Bureau report.
The ACA attempts to address these health disparities in a number of ways.
Research
Before the problem can appropriately be solved it must first be fully understood. To that end, Congress funded the National Institute on Minority Health and Health Disparities with $831 million for scientific research on how to improve minority health and eliminate health disparities. [2]
Expansion of Medicaid
Since many minority groups tend to suffer from higher levels of poverty, they also tend to rely more on programs such as Medicaid. Medicaid covers nearly 40 percent of African-American and Latino children. The ACA expands coverage in 2014 up to 133 percent above the poverty level. Nearly half of the current group of uninsured people would qualify for Medicaid under this new criteria. [3]
Community health centers
The ACA provides $11 billion in funding to double the number of patients that are provided primary and preventative services by community health centers. In 2009, 34 percent of health center patients were Hispanic or Latino and 28 percent were African American.
Employer mandate
In addition, the ACA will attempt to expand employer-provided health insurance coverage to many minorities who work in lower-paying jobs. Under the law, employers with more than 50 employees will have to pay a fine if any of their employees receive a premium credit for purchasing their own insurance because they were not offered insurance from their employer. [3]
Summary
Minorities have historically suffered from worst health outcomes in the United States due to a number of factors. The ACA attempts to expand health insurance coverage for minorities and improve overall health through research, public programs and mandated private insurance.
[1] http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=1&lvlID=7
[2] http://www.ncsl.org/documents/health/HDandACA.pdf
[3] http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8016-02.pdf
Ryan Witt is a freelance writer covering all things St. Louis Cardinals. His work can be found on Examiner.com.
