ACA has only reduced the number of uninsured slightly, has not reduced racial disparities

[Baobab]

in health as much as needs to be done.

Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage

Thomas C. Buchmueller, PhD, Zachary M. Levinson, MPP, Helen G. Levy, PhD, and Barbara L. Wolfe, PhD

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303155


CONTRIBUTORS

All authors contributed to the analysis and the writing of the article.

ABSTRACT

Objectives. To document how health insurance coverage changed for White, Black, and Hispanic adults after the Affordable Care Act (ACA) went into effect.

Methods. We used data from the American Community Survey from 2008 to 2014 to examine changes in the percentage of nonelderly adults who were uninsured, covered by Medicaid, or covered by private health insurance. In addition to presenting overall trends by race/ethnicity, we stratified the analysis by income group and state Medicaid expansion status.

Results. In 2013, 40.5% of Hispanics and 25.8% of Blacks were uninsured, compared with 14.8% of Whites. We found a larger gap in private insurance, which was partially offset by higher rates of public coverage among Blacks and Hispanics. After the main ACA provisions went into effect in 2014, coverage disparities declined slightly as the percentage of adults who were uninsured decreased by 7.1 percentage points for Hispanics, 5.1 percentage points for Blacks, and 3 percentage points for Whites. Coverage gains were greater in states that expanded Medicaid programs.

Conclusions. The ACA has reduced racial/ethnic disparities in coverage, although substantial disparities remain. Further increases in coverage will require Medicaid expansion by more states and improved program take-up in states that have already done so. (Am J Public Health. Published online ahead of print May 19, 2016: e1–e6. doi:10.2105/AJPH.2016.303155)

[raging moderate]

1. Good for the ACA!

This is good news, and this progress gives us something to build on. I vote we keep trying to do even better.

[Baobab]

2. How do you think its going to take, based on our progress to date?

During that time there have been around 1.5 million excess deaths since 1992.

[scscholar]

3. And the largest chunk of those deaths that weren't natural...

were caused by medical mistakes. We need to hold the doctors accountable.

[Baobab]

8. I don't follow your logic. I am not talking about iatrogenic injury.

Its a very specific thing, excess deaths amenable to improved access to health care.

Maybe 1.5 to 2 million people are missing from this planet because of our screwed up health care system's exit being prolonged for two decades when there was no conceivable logical reason to do that.

[raging moderate]

18. That depends on how soon we can flip Congress.

And make the necessary changes.

[Doctor_J]

20. We had huge majorities when this abomination was passed. The owning class got exactly what they

wanted, and there won't be any "necessary changes" coming. Open your damn eyes.

[pkdu]

4. So 4 supposedly smart people took data from 2008-14

And used it to make conclusions about the effects of a law which , although signed in 2010 , didn't have its major aspects Implemented until Jan 24th 2014.

Academic Fail.

[Baobab]

6. Read the paper, it took that into consideration.

AJPH = US leading journal of public health.

Attacking the source is not constructive here.

We have to fix these things but trade deals being pushed by our own leadership are attempting to make that impossible, forever, fast. Read the URLs below this post

[WhiteTara]

9. By allowing the republicons to retake the WH

while keeping the Senate and House and taking over the SCOTUS is really not constructive either.

[TexasBushwhacker]

5. If all the states allowed the Medicaid expansion

the numbers would be dramatically better.

[Baobab]

7. Medicaid is only available to people who are nearly destitute

Is it a good think to make it so people with quite treatable medical conditions can only "afford" care if they are unemployed or making next to nothing?

Automation is replacing low skill jobs at an exponentially increasing rate, people need to work now and save money.

If the stupid policy forces people to leave jobs, who will have any money to live off of?

Without several PhDs, they are just going to have whatever they save now, while work is still available.

[TexasBushwhacker]

10. But the ACA also provides assistance for singles

making up to about $40K and families higher than that. It's scaled so that the less you make the most assistance you get.

In any case, while the ACA is far from perfect, in the states that accepted the Medicaid expansion a person or family can make up to 133% of the federal poverty level and be eligible for Medicaid. For a family of 4 it's up to almost $30K per year. Are they still poor? Of course! But it's not "next to nothing". Of course this family would also be eligible for EITC and SNAP. Even a single person with no kids would be eligible for Medicaid with an income up to over $15K. But the problem is that it's up to the states.

I realize that automation and shipping jobs overseas means fewer and fewer jobs, but that's really a whole other issue. I do think that at some point we will have to have some kind of guaranteed minimum income. I'm almost 60, so I doubt it will happen before I retire, but it does need to happen.

[Baobab]

11. the most important thing in there is the limit on OOP costs

because OOP costs can be astronomical.. please dont tell me that limit is not still there, I keep expecting them to take it out.

if only people who made a penny more could be protected too..

The number of people who are actually getting Obamacare is pretty small and the number of people who arent for one reason or another is pretty large.

many people cannot afford it. the out of pocket costs are too large. Imagine somebody paying the maximum OOP costs $12000 a year plus premiums and its n astronomical sum. people who have some chonic condition have to pay that often because drugs are expensive as can be and going up fast.

[Baobab]

12. Its not far from perfect, you're being way too kind.. Not just that but its the latst in a chain of

failures that are all basically pretty much the same, did you know that?


Read this: http://www.pnhp.org/states_flatline/State%20Health%20Reform%20Flatlines%20IJHS%20-%202008.pdf

[TexasBushwhacker]

14. Hey, I'd much prefer single payer paid with payroll taxes

If nothing else the ACA allows people to get coverage if they have pre-existing conditions. It also requires parity for the treatment of mental illness. Just adding a public option would make it more affordable.

[Baobab]

16. Single payer is free, it has to be and its the only means of payment, there are no tiers, no pay mor

no pay more and get more pay less and get less. As such it violates every trade agreement we're ever entered.

How can we have been so stupid? they didnt tell us thats how. instead we were treated to a good cop bad cop routine in 1994.

[Igel]

17. That's why it's a bit of a tough sell.

You pay more, you get the same. You pay less, you get the same. You pay nothing, you get the same.

Single payer is free like the US military engagement in Afghanistan is free.

[Baobab]

13. they run into something called competition policy, to be more specific 'crowd out'

which is a free trade ideology thing.

It never existed before the current madness of trade deals-

and its nuts in this context..

[TexasBushwhacker]

15. Competition, free trade yada yada yada

Should NOT apply when it comes to healthcare, education, etc. They are some things that just don't work well as for profit businesses.

[Doctor_J]

19. Its main purpose was to force everyone into our worst-in-the-world system. The death merchants are

are reaping historic profits, tens of millions are still without, people with company plans are bearing the cost, and we are now stuck with it for another fifty years. The ACA was a complete success at preventing the country from getting healthcare as a right.