In States Failing to Expand Medicaid, People of Color are Disproportionately Left Uninsured

Jul 17, 2013

By Lavanya Mohan

More than 45 million people in the U.S. are uninsured. If every state expanded Medicaid coverage as intended under the Affordable Care Act (ACA), almost 25.4 million would be eligible to enroll in Medicaid. However, the recent Supreme Court decision on the ACA has effectively made Medicaid expansion a state decision. So far, 23 states and the District of Columbia have elected to expand coverage on January 1, 2014.  Conversely, 21 states have declined to expand Medicaid with an additional six states that are on the fence. This means that fewer people will be able to obtain health insurance. A recent report further finds that low-income individuals of color will be disproportionately affected by state decisions on whether or not to expand Medicaid.

Among the 27 states that have not elected to expand Medicaid on January 1, more than 27.4 million people remain uninsured, of which about 14.7 million would be eligible for Medicaid if their states adopted the ACA Medicaid expansion. In the 21 states that have formally declined expansion, almost half of the uninsured residents are people of color. According to the Kaiser Family Foundation, “people of color make up the majority of uninsured individuals…in states moving forward and not moving forward with the Medicaid expansion.” Fifty-nine percent of African-Americans and 44 percent of Hispanics live in states that are not moving forward with Medicaid expansion, with African-Americans most at risk of coverage gaps.

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