Published On: Mon, Mar 20th, 2023

The Affordable Care Act has significantly reduced racial disparities in healthcare access, report says

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The Affordable Care Act, passed in 2010 by former President Barack Obama, has expanded health insurance coverage across the U.S. and significantly reduced racial and ethnic disparities in access to healthcare, according to a new report by the Commonwealth Fund.

Percentage of U.S. adults ages 19–64 who are uninsured, by race/ethnicity
Coverage inequities between Black, Hispanic, and white adults have narrowed substantially since 2013. All groups reported improvements between 2019 and 2021.

The Commonwealth Fund


“Since its passage in 2010, the Affordable Care Act (ACA) has helped cut the U.S. uninsured rate nearly in half while significantly reducing racial and ethnic disparities in both insurance coverage and access to care — particularly in states that expanded their Medicaid programs,” reads the report.

Data shows that prior to the 2013 implementation of the Medicaid expansion — a provision of the ACA that made more families eligible for Medicaid coverage — 40.2% of the Hispanic population, 24.4% of the Black population, and 14.5% of the White population were uninsured in America. However, by 2021, those numbers dropped significantly to 24.5%, 13.5%, and 8.2%, respectively.

Percentage-point change in uninsured rate for U.S. adults ages 19–64 from 2019 to 2021, by state and race/ethnicity
Uninsured rates for Black and Hispanic adults improved considerably in several states between 2019 and 2021, while white adults experienced modest gains in most regions. 

The Commonwealth Fund


With more than five million people gaining coverage between 2020 and 2022 over the course of the pandemic, the overall uninsured rate in the U.S. dropped to just 8%, a historic low, according to the report.

The report highlights specific ACA successes, including improved coverage rates for Black, Hispanic and White adults.

“The coverage gap between Black and White adults dropped from 9.9 to 5.3 percentage points, while the gap between Hispanic and White adults dropped from 25.7 to 16.3 points,” according to the the study. 

Additionally, the report found that adult uninsured rates for Black, Hispanic, and White people all improved during the first two years of the pandemic across all states — whether they had expanded their Medicare coverage or not —  and that Black and Hispanic adults experienced larger gains in insurance coverage than their White counterparts between from 2019 to 2021.

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