NEW YORK, March 16, 2022 — During the COVID-19 pandemic, uninsured rates reached record lows for Black, Hispanic, and white adults, driven by the Affordable Care Act (ACA), additional states expanding Medicaid eligibility, and policies that increased marketplace and Medicaid enrollment. Between 2013 and 2021, uninsured rates fell 15.7 percentage points for Hispanic adults, 10.9 points for Black adults, and 6.3 points for white adults, according to a new Commonwealth Fund report.
The report, Inequities in Health Insurance Coverage and Access for Black and Hispanic Adults: The Impact of Medicaid Expansion and the Pandemic, examines how adults’ health care coverage and access for Black, Hispanic, and white Americans changed during the 2019–21 period and analyzes earlier health care trend data for these groups beginning in 2013, the year before the ACA’s major coverage expansions went into effect. Since 2019, seven states — Idaho, Maine, Missouri, Nebraska, Oklahoma, Utah, and Virginia — have expanded Medicaid. Meanwhile, the Families First Coronavirus Response Act of 2020 required states to keep Medicaid enrollees covered continuously throughout the COVID-19 public health emergency. In addition, the American Rescue Plan Act temporarily enhanced marketplace premium subsidies. Key findings from the report include:
- Coverage disparities between Black and Hispanic adults and white adults narrowed considerably from 2013 to 2021. The insurance gap between Black and white adults dropped from 9.9 to 5.3 percentage points, and the gap between Hispanic and white adults dropped from 25.7 to 16.3 points.
- From 2019 to 2021, uninsured rates for adults across racial and ethnic groups improved. Increased marketplace and Medicaid coverage helped lower uninsured rates in both Medicaid expansion and nonexpansion states. Black and Hispanic adults experienced larger Medicaid and individual-market coverage gains than white adults during this period.