Two-thirds of people who would gain coverage in non-expansion states are people of color
Petersburg, Va. — Virginia Organizing released a new issue brief today highlighting racial equity in health care policies as the nation prepares to commemorate Juneteenth, which marks the emancipation of enslaved people in the United States.
The report describes how Congress and the Biden Administration can reduce racial disparities that result in worse health outcomes and diminished economic security for Black and Brown people by prioritizing policies that make health care affordable and expanding coverage.
Specifically, the report details how closing the Medicaid coverage gap in 12 states that have not yet expanded Medicaid would increase health equity. About 4 million low-income people could gain coverage under Medicaid if these states expand Medicaid, including 2.2 million adults with incomes below the poverty line. Of this number, 28 percent are Black and another 28% are Latino. Medicaid expansion in these states would finally finish the job of implementing the Affordable Care Act, which now covers 31 million people, the largest number in its history.
The ACA brought the number of uninsured people to historic lows and narrowed health disparities. Latinos, Blacks, and Native Americans had higher percentage point increases in coverage than whites since these groups were all more likely to be uninsured before the ACA was implemented.
In Virginia, 692,277 residents have gained health coverage through the Affordable Care Act, including 494,240 newly eligible through Medicaid as of February 2021. Since 2013, the rate of uninsured dropped from 12.3 percent in 2013 to 7.9 in 2019.
Medicaid expansion has a proven track record of reducing health disparities. Yet, three-fourths of states that have not expanded Medicaid despite increased incentives under the American Rescue Plan are in the South, including Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Three of these states (Texas, Georgia, Florida) also have the largest number of non-Hispanic Black people in the country. Texas and Florida are also among the top five states with the largest populations of Hispanic Blacks.
“The ACA made huge strides in improving health care for Black and Brown people, but the job isn’t finished as long as partisan opponents of the ACA can continue to block the implementation of Medicaid expansion in a dozen states,” said Sandra A. Cook, a member of Virginia Organizing’s State Governing Board. “Our state and the many others who have implemented the law and covered millions of people provide a track record that these policies work. Everyone in America should have the same access and opportunity that we’ve been able to offer here in Virginia.”
Georgia Senators Warnock and Ossoff wrote a recent letter urging Congress and the Biden Administration to take action to create a federal solution for people denied Medicaid coverage because of political gridlock that would allow people in non-expansion states to access affordable health care.
Doing so would build on other improvements that emerged in ARPA that expanded premium tax credits and gave millions more people access to quality, affordable health care with lower premiums.
More than a third of enrollees have a plan that costs $10 or less per month including 4 in 10 new enrollees. ARPA increased funding to address maternal health by extending health coverage for new mothers, gave states the option to expand home based and community services and provided subsidized COBRA coverage for laid off and unemployed workers. The rescue plan also increased funding for Medicaid expansion as an incentive to states to finally expand coverage to the uninsured, but none of the dozen states took up the funding.
Members of the Black, Hispanic, and Asian Congressional Caucuses are now working together to advance closing the coverage gap as a key strategy to address racial health disparities, starting with a Tri Caucus sign on letter. Virginia Organizing members want to thank Rep. Don McEachin for signing the letter, and they urge Reps. Bobby Scott, Gerry Connolly, and Jennifer Wexton to join this effort to finally ensure everyone has access to Medicaid.
“Health equity is not a blue state or a red state issue,” said Dr. Makunda Abdul-Mbacke, a leader in the Martinsville/Henry County Chapter of Virginia Organizing. “No matter where someone lives or what they look like, no one should be denied access to quality health care based on political grudges. Many other states, Democratic and Republican led, have put the interests and needs of their constituents ahead of their own partisanship. Politicians in the remaining states should not be allowed to hold low-income people, Black and brown people hostage to their agenda. Biden and Congress must intervene and there’s never been a better time.”
Sandra A. Cook, Dr. Makunda Abdul-Mbacke, and more than 110 members of Virginia Organizing participated in a panel discussion of Racism as a Public Health Crisis with special guest Del. Lashrecse Aird on June 17. Participants acknowledged that even though Virginia has expanded Medicaid, many barriers still prevent people of color from accessing health care because of ongoing systemic racism and biases among providers.
In thanking the panelists, Sandra A. Cook said, “We realize that we have a lot of work to do. Virginia Organizing has been working on dismantling racism for 25 years, and we’re in it for the long haul.”
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