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Despite Affordable Care Act millions could go without health insurance

By Starla Muhammad -Assistant Editor- | Last updated: Feb 6, 2014 - 8:55:35 AM

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( - Though 2014 marks the 50th anniversaries of both the War on Poverty and Civil Rights Act, glaring racial disparities continue permeating the fabric of American society. Stark differences between Blacks and Whites in education, employment, poverty, housing and net worth, are tied to health disparities and access to health insurance coverage, according to this year’s State of the Dream Report.

The report is released annually by United for a Fair Economy to coincide with the King Holiday and examines areas of racial inequality.

“Racial segregation in concentrated poverty effectively creates a toxic soup of health problems and challenges in communities of color,” said Brian Miller, executive director of United for a Fair Economy in a conference call with reporters.

This year’s report, titled, “State of the Dream 2014: Healthcare For Whom? Enduring Racial Disparities” zeroes in on the Affordable Care Act.

The U.S. Supreme Court upheld key portions of the ACA, dubbed “Obamacare” in 2012. But the high court’s ruling also gave each state the authority to opt out of the Medicaid expansion program. The report warns this means millions will still not have health insurance.

Twenty-five states, the majority headed by Republican governors have said or indicated they will reject the expanding Medicaid, said the State of the Dream report. The federal government pays for additional health coverage offered under the Medicaid program but many GOP leaders who fought Obamacare also refuse to accept any funding linked to the program.

“This new 25-state coverage gap will leave millions of Americans without health insurance while exacerbating racial disparities in health and healthcare,” the State of the Dream 2014 report warned.

If states opt out, the report said:

*Nearly 5 million people who would have otherwise been covered—disproportionately people of color—will go without health insurance.

*Blacks though 13 percent of the population would represent 27 percent of those who would not have insurance.

With the exception of Arkansas, every state in the South, where the majority of Blacks live, is rejecting Medicaid expansion, said Mr. Miller.

According to the U.S. Census, in 2010, 55 percent of the Black population lived in the South, and 105 Southern counties had a Black population of 50 percent or higher.

Blacks and Latinos are pushed into low income, high poverty communities where health problems, lack of access to both health facilities and full service grocery stores are common, said Mr. Miller.

Those groups are also less likely to secure jobs that provide employer provided healthcare, he added.

Medicaid is the federal and state program that provides health coverage to 50-60 million pregnant women, families, children, people with disabilities and the elderly.

To qualify for Medicaid coverage, a family can have an income that is up to 133 percent of the federal poverty level, which was about $29,700 for a family of four in 2011. The federal poverty level is revised yearly. The federal poverty level in 2013 was $23,550 for a family of four. 

The Supreme Court ruled the federal government could not force states to expand Medicaid by withholding federal money they would otherwise receive for programs that already exist under Medicaid. 

A single payer healthcare system where government instead of private insurers pays healthcare costs would be ideal but until then the ACA and pushing for Medicaid expansion is a step toward closing disparities in health insurance, said analysts that agreed with the United For a Fair Economy report.  

United for a Fair Economy hopes this year’s findings, when examined, will result in a better understanding of the ACA and the importance of Medicaid expansion.

“People in states that have opted out are going to say, ‘Oh God, I don’t have health care coverage, this Obamacare program’s a failure.’ Instead of blaming it on the fact that their state policy makers chose not to expand Medicaid they may unfortunately in some cases blame the original legislation and view it as a failure of that. Which it is not,” said Mr. Miller.

Dedrick Muhammad, senior director of the NAACP Economic Department, was one of several policy experts that reviewed and contributed feedback on this year’s State of the Dream report. Despite it being the second term of the country’s first Black president, racial inequities are still very much a reality, he said. Some of the findings show racial disenfranchisement is being further cemented into society, Mr. Muhammad added.

“This really goes to the heart of what Dr. King says; of all forms of inequality, injustice in healthcare is the most shocking and inhumane. We agree and that’s why we wrote this report,” said Mr. Miller.

A copy of this year’s 11th annual State of the Dream report can be downloaded at