How the Affordable Care Act Has Narrowed Racial and Ethnic Disparities in Access to Health Care

The insurance coverage expansion ushered in by the Affordable Care Act (ACA) has significantly increased Americans’ ability to get the health care they need since the law’s main provisions went into effect in 2014. Research also indicates that the ACA narrowed racial and ethnic disparities in insurance coverage1 — a key objective of the law, and one that enjoys substantial public support.2

In this brief, we examine how much the ACA also has reduced disparities in access to health care among black, Hispanic, and white adults. Using data from the federal American Community Survey (ACS) and the Behavioral Risk Factor Surveillance System (BRFSS) for the years 2013 to 2018, we review:

differences in the share of black, Hispanic, and white adults who are uninsured (ages 19 to 64)
differences in the share who went without care because of cost in the past 12 months (ages 18 to 64)
differences in the share with a usual source of care (ages 18 to 64).

We examine the degree to which racial and ethnic differences have narrowed since the ACA went into effect, what differences exist between states that have expanded Medicaid and those that have not, and which policy options might further reduce disparities.

We hope these findings will help guide policymakers as they consider options for moving the nation closer to a more equitable, higher-performing health care system.