Racial/Ethnic Differences in Uninsurance Rates under the ACA

Lisa H. Clemans-Cope, Urban Institute
Genevieve M. Kenney, Urban Institute
Matthew Buettgens, Urban Institute
Hannah Recht, Urban Institute

This report is the first state-level projection of ACA coverage gains for racial/ethnic groups. This presentation will include a special focus on coverage projections for the 11 largest Latino-origin groups (Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, Colombian, Honduran, Ecuadorian, Spaniard, and Peruvian) and three other categories (Other South American, Other Central American, and Other Latino not specified). Absent ACA coverage provisions, Latinos, blacks, and American Indian/Alaska Natives are overrepresented among the uninsured. With the ACA and current state Medicaid expansion decisions, uninsurance rates are projected to fall for each racial/ethnic group, narrowing coverage differences between whites and each minority group, except for blacks. If all states were to expand their Medicaid programs, we project that uninsurance rates would fall further for all racial/ethnic groups, with blacks experiencing a marked reduction. Effective outreach can further reduce uninsurance rates for all racial/ethnic groups.