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Racial, Ethnic Health Coverage Disparities on the Decline, HHS Says

By Rebecca Adams, CQ Roll Call

March 16, 2015 -- Minorities have gained health insurance at higher rates than white Americans since the marketplaces created by the health care law opened in October 2013, Health and Human Services (HHS) officials said last week when releasing a report that found 16.4 million people gained insurance since 2010.

African-American and Latino adults still remain less likely to have health coverage than white people. However, the disparities are declining.  

HHS Secretary Sylvia Mathews Burwell called the increases in insurance rates "the largest reduction in the uninsured in four decades."

Before the marketplaces opened, about 14.3 percent of white adults did not have coverage, compared to 22.4 percent of African-Americans and 41.8 percent of Hispanics, according to the HHS report. As of March 4, about 9 percent of white adults were uninsured, compared to 13.2 percent of African-Americans and 29.5 percent of Latinos.

The improvement is "not probably exactly where you want to be because the numbers are still high," Burwell recently told reporters.

"We did a lot of things to highly target those communities," said Burwell. "I believe we can do more."

She noted that she held a large number of events focused on urging minorities to sign up for coverage, including Google hangouts, visits to African-American churches, and an increased percentage of ad buys on Spanish-language media. HHS officials are now analyzing which efforts worked.

Hispanic adults stand out because they are less likely to have employer-sponsored insurance and because people who are in the country illegally are not eligible to buy insurance through marketplace plans created by the health law. Those who live in states that have not expanded Medicaid to more people also have fewer opportunities for coverage.  Nationwide, about 1.5 million Latinos would gain coverage if all states expanded, said Steven Lopez, a health policy expert at the National Council of La Raza, an advocacy group. About 1 million of them live in just two states: Florida and Texas.

"We're encouraged by what we see as an upward trajectory," said Lopez. "But we know it's going to take time to bring those numbers down."

Lopez and other advocates are encouraging HHS officials to tweak their outreach efforts and make it easier for people without a long credit history to verify their identities so that they can get coverage.

The HHS numbers indicate the percentage of adults over the age of 18 who have coverage. HHS officials are expected to release more comprehensive data including children later this year.

For young adults between the ages of 19 to 25, the uninsured rate dropped from 34.1 percent to 26.7 percent since 2010. The law allows young adults to stay on their parents' coverage until age 26, in addition to providing new coverage options for some young adults through marketplace insurance or Medicaid.

The HHS analysis was based in part on previously reported survey data from 27,800 adults through the Gallup-Healthways Well-Being Index survey, which was released on March 4. That information showed that 12.3 percent of the U.S. population is uninsured. The organization will release new numbers in early April.  The agency also used previously reported data from the National Health Interview Survey conducted by the U.S. Census Bureau.

About 40 million adults were uninsured before insurers started selling insurance through the marketplaces in 2013, and about 26 million adults are currently uninsured, based on data extrapolated from the uninsured rates.

The report and remarks by Burwell come as part of the administration's publicity around the upcoming anniversary of the health care law, which President Barack Obama signed almost five years ago.

The news comes as federal and state officials are waiting for a ruling, expected to probably come in June, on whether federal tax subsidies should be available in states that did not create their own state-run enrollment marketplaces.

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