Before the Affordable Care Act (ACA) in 2010, many people from Hispanic, Black, Asian, AIAN, and NHPI backgrounds did not have health insurance. The Hispanic and AIAN groups faced the biggest challenges, mainly due to limited access to affordable healthcare options. Even though most families had at least one full-time worker, systemic issues in employment and income meant that many could not afford health coverage. Medicaid helped some, but even that had strict eligibility rules—many parents could only qualify if they earned very low incomes, and adults without children were often excluded altogether.
Between 2010 and 2016, the ACA changed that. It led to more coverage options for low- and moderate-income families. Key features included allowing young adults to stay on their parents’ plans until 26 and preventing insurers from denying coverage based on health conditions. By expanding Medicaid to more adults with lower incomes and providing tax credits for those buying insurance, the ACA significantly increased coverage. From 2014 to 2016, the uninsured rate among Hispanic people dropped from 24.8% to 19.1%. Black and AIAN groups also saw improvements but still lagged behind White individuals.
However, after 2016, things took a turn. The uninsured rate crept up for three straight years, hitting 10.9% by 2019. Most notably, the Hispanic uninsured rate showed a slight rise. This trend coincided with policy changes under the first Trump administration that reduced funding for outreach and made it harder for some to access Medicaid.
The COVID-19 pandemic brought unexpected changes. Between 2019 and 2023, uninsured rates actually dropped, with about 3.6 million people gaining coverage. The surge in Medicaid enrollment played a big role, driven by pandemic policies like the Families First Coronavirus Response Act, which made it harder to lose coverage and expanded federal aid to states.
Unfortunately, this positive trend didn’t last. In 2024, the uninsured rate among those under 65 climbed back up to 9.8%, affecting about 26.7 million individuals. Hispanic, Black, and White populations all saw increases in their uninsured rates. Despite gains in the past, coverage gaps have persisted—and in some cases worsened. For instance, the uninsured rate among AIAN people remains alarmingly high compared to White people, widening from 2.4 times higher in 2010 to 2.9 times higher in 2024.
Experts underline these ongoing disparities as concerning. Richard Frank, a health policy expert at Harvard, notes that addressing these inequalities is crucial for a healthier society. The ACA made a difference, but continuous efforts are needed to ensure everyone has access to affordable healthcare.
While many have benefited from expanded coverage, it’s clear that the journey to equitable healthcare continues.
Source link
American Indian or Alaska Native,Asian,Black or African American,Coverage,Hispanic or Latino,Native Hawaiian or Pacific Islander,Public Health,Race\/Ethnicity
