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Minorities Disconnected from Medical Home, Coverage

Analysis of the Commonwealth Fund Biennial Health Insurance Survey (2005) finds that many Hispanic and African American working-age adults are "disconnected" from the health care system. According to Health Care Disconnect: Gaps in Coverage and Care for Minority Adults, by Fund researchers Michelle M. Doty, Ph.D., and Alyssa L. Holmgren, Hispanic and African American adults are more likely than their white counterparts to experience gaps in insurance coverage, lack access to health care, and face medical debt.

Sixty-two percent of Hispanic adults ages 19 to 64—an estimated 15 million adults—were uninsured at some point during the year, a rate more than three times as high as that for white working-age adults (20%). Uninsured rates for working-age African-American adults were also steep, with one-third (33%) uninsured or experiencing a gap in coverage during the year.

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Uninsured rates for low-income Hispanics particularly stood out: three-quarters (76%) of Hispanic adults with incomes below 200 percent of the federal poverty level experienced a time uninsured, compared with 44 percent of African Americans and 46 percent of whites with low incomes.

"These findings are extremely troubling, and indicate missed opportunities to ensure a healthy and productive workforce," says Fund President Karen Davis. "Minority Americans face persistent disparities in rates of health care coverage, as well as cost and access barriers to care even when they do have health insurance."

Along with expanded coverage, policies promoting continuity in patients' relationships with providers, the authors said, also are needed to reduce access disparities.

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