Why Medicaid Matters for People of Color
Dawn GodboltDr. Dawn Godbolt is a Health Equity Fellow at the Center for Global Policy Solutions, where she focuses on policy and research developments related to the social determinants of health and health equity. She recently finished her Ph.D. in Sociology at Florida State University and is passionate about reducing health disparities in communities of color. William Kay is a National Academy of Social Insurance Intern at the Center for Global Policy Solutions. A rising senior at Carleton College, his interests include income security, social insurance, and wealth-building.
Medicaid is the country’s single largest source of health care coverage, with 73 million enrollees. In 2015, almost 60% of Medicaid enrollees were people of color. It narrows the health disparities gap by providing people of color with access to health care, specifically preventative care, which prevents treatable diseases from metastasizing into chronic conditions. Due to historical discriminatory policies, minorities tend to be disproportionately impoverished, underemployed, and less able to access health care through private insurers. Medicaid gives a large number of minorities access to health insurance and an overall improved quality of life.
Here are three brief outlines of how Medicaid helps communities of color:
- Medicaid and the Children’s Health Insurance Program (CHIP) provide health insurance to more than half of all minority children. This is a significant investment in the human capital of minority communities that has long-term benefits. Minority children who have insurance are more likely to have better academic outcomes and economic opportunities as adults. For minority children, Medicaid is a pathway to successful adulthood.Almost 30% of African-American adults are covered by Medicaid.
- The Affordable Care Act (ACA) and the expansion of Medicaid saw the uninsured rate for African-Americans drop from 17% to 12%. However, the non-expansion of Medicaid disproportionately affected African-Americans who are concentrated in the South, where the majority of states chose not to expand Medicaid. The lack of expansion is partially responsible for the gap between black and white health coverage remaining unchanged.
- Indian Health Services is the primary source of health care for American Indians and Alaska Natives (AINAs) and historically has been underfunded. Consequently, AINAs fare worse than whites across health measures, and Medicaid covers 1 in 3 adult AINAs and half of AINA children. In 2016, the Medicaid and Medicare Services Office decided to reimburse states 100% of the cost of care for AINAs. Without Medicaid, a large proportion of AINAs would lack access to care.
Understanding Medicaid’s impact on communities of color is a pressing issue. Since Medicaid’s implementation, minorities have seen an increase in longevity, a reduction in infant mortality, and less cases of chronic disease. In the current political climate Medicaid is at risk. Many Medicaid opponents advocate for a restructuring of the program into a per capita allotment structure. If Medicaid were to switch to this model or a block grant model, federal dollars allocated to states would be set at a pre-determined amount, not on the true cost of care. Theoretically, this would force states to choose who amongst their most vulnerable citizens would remain eligible. Given that minorities disproportionately use Medicaid, it is important that changes to it advance the health of marginalized groups, rather than placing a price tag on the value minority health.