Health Coverage Rates Vary Widely Across — and Within — Racial and Ethnic Groups

Uninsured Rates Vary Across and Within Racial and Ethnic Groups Uninsured rates are higher among Latino,4 American Indian and Alaska Native (AIAN), Black, and Native Hawaiian and Pacific Islander (NHPI) people than among Asian, white, and multiracial people.5 (See Figure 1.) Latino people experience particularly high uninsured rates –two to three times the rates experienced by Asian, white, and mu. [...] Progress stalled and uninsured rates rose slightly beginning in 2017 and through 2019, in part due to the repeal of the individual mandate and Trump-era policies that took aim at the Affordable Care Act and made health coverage through the ACA marketplaces less affordable.6 The Trump Administration also depressed enrollment in the ACA marketplaces by reducing funding for outreach and enrollment as. [...] During 2024’s open enrollment period for the ACA marketplace, for example, nearly half of enrollees’ races and ethnicities were unknown.27 Agencies can take measures to encourage responses, such as allowing for the selection of a “decline to answer” option and making the question mandatory, providing clear explanation of the uses of such data collection, improving question format, and leveraging o. [...] In non-expansion states, the uninsured rate among this group fell much more modestly, from 44 percent in 2013 to 30 percent in 2022.66 Adults of all racial and ethnic groups experience higher rates of coverage in Medicaid expansion states, and there is evidence of narrowed inequities between groups in coverage and access after expansion.67 (See Figure 8.) 11 FIGURE 8 The effects of states’ decisio. [...] Looking Ahead Inadequate health coverage is one of the greatest barriers to accessing care, and the unequal distribution of coverage contributes to health inequities.115 Racial health coverage inequities are less stark in states that have expanded Medicaid eligibility, and closing the Medicaid coverage gap is key to reducing these coverage inequities in non-expansion states, particularly among peo.