Insurance coverage

Communities of color see big gains in health insurance coverage


Registered color communities huge gains in health insurance coverage from 2020 to 2022 due in large part to improved affordability and increased outreach efforts to enroll people, according to a report this week from the Department of Health and Social Services.

During this period, Hispanics saw their enrollment rates increase 53% in the Affordable Care Act insurance market, Blacks 49%, and Native Americans 32%.

The report, which was produced by researchers from the Office of the Assistant Secretary for Planning and Evaluation at HHS, analyzed market enrollment trends by race and ethnicity from 2015 to 2022 and showed that health insurance coverage rates have improved across the board over the past two years. The growth of Black and Latino communities, where rates of uninsurance have historically been the highest, outpaced other groups, increasing by nearly 40% for both groups between 2021 and 2022, the report said.

Still, gaps remain about who has health insurance, with 25.7% of adult Latinos under 65 uninsured at the start of 2022, compared to 14.8% of black adults and 6.9% of white adults. , according to the report.

“This underscores the importance of outreach and enrollment support,” said Cynthia Cox, vice president of the Kaiser Family Foundation, where she is also program director on ACA. “We know a lot of people, especially Hispanics, were eligible for free or reduced-cost coverage but weren’t taking it.”

Cost has certainly been a barrier to access. But the reasons often go beyond dollars and cents, Cox said, encompassing a host of factors that include immigration status, limited internet and computer access, and word-of-mouth information that could not apply to an individual’s situation.

The ACA is sprawling health care legislation that passed a Democratic Congress and has become a source of partisan warfare ever since.

President Donald Trump was a vehement foe of the law, which allows more low-income people to enjoy public health insurance coverage, and his administration attacked the insurance markets created for consumers who cannot obtain affordable benefits through employment. Most people who buy market plans receive federal subsidies.

The Trump administration has cut federal funds for advertising, community outreach and “navigators” who serve as enrollment coaches helping people navigate the Byzantine system of plans and grants.

“The Biden administration, when it came in, not only restored the dollars that were there before, but increased them,” said Linda J. Blumberg, research professor at Georgetown University and member of the Urban Institute whose recent work analyzes ACA.

This “significant new influx of dollars and aid” – coupled with increased subsidies for market buyers via the US bailout, credits extended to 2025 by the Inflation Reduction Act – means that “We have a situation where the dollars available to reduce the price of hedging the market…is much better,” Blumberg said.

The coronavirus the Congressional Relief Act passed in March 2021 contained the first expansion of federal grants for ACA health plans in the history of the program. The law increases tax credits for monthly insurance payments and allows people with higher incomes to qualify for assistance.

In August 2021, the Biden administration awarded $80 million in grants to approximately 60 organizations, quadrupling the number of navigators to more than 1,500. These navigators hosted more than 1,800 outreach events at libraries, clinics in vaccinations, food drives, county fairs and job fairs, the administration said.

This year, the administration announced it was providing nearly $99 million in grants to those same organizations so they can retain staff and hire more people to help consumers find coverage during the coronavirus pandemic. 2023 open registration, which begins Tuesday. People can apply through health.govthe federal insurance market on which 33 states rely.

A record 14.5 million people signed up for health cover in the insurance markets in 2022, meaning many people will be shopping to renew their cover for the first time when the open registration will begin.

“One thing that’s really important for people to know is that if they don’t actively purchase on November 1, they’ll automatically be re-enrolled in the same plan, but the cost can change significantly from year to year. ‘other,” Cox said. . “It’s not just about getting people in the door in the first place, but making sure they’re able to maintain their coverage year after year.”

According to the federal report, the national rate of the uninsured hit “an all-time high” in early 2022. And that, health policy experts say, is a good thing because it improves access to medical care. Being uninsured means being less likely to have health care needs met, which translates to later diagnosis of illness, receipt of lower quality care, and increased financial risk in the event of a medical emergency. .

“We also saw public health emergency provisions during the pandemic that allowed for a new enrollment period for people enrolling in the federal market and greater flexibility to remain enrolled,” said Katherine Baicker, dean of the Harris School of Public Policy at the University of Chicago. States, for example, were not allowed to kick anyone out of Medicaid during the pandemic in exchange for increased federal dollars to support the public insurance program.

“We’re going to see some of these provisions expire when the national public health emergency expires,” Baicker said. “It can lead to some loss of insurance for people.”

Georgetown’s Blumberg agrees that “a good portion” of the population will lose Medicaid coverage when the public health emergency ends, but she thinks she will be eligible for subsidies to make market coverage more affordable.

The expanded the tax credits expire in three years, which according to Margaret A. Murray, founder and CEO of the Association for Community Affiliated Plans, is troubling.

“We wanted them to be permanent,” said Murray, whose trade organization represents more than 70 nonprofit social protection schemes that provide coverage for more than 20 million people with low incomes and health needs. complex. “You can’t solve some of the health equity issues without people being covered, but we want to make sure people aren’t lured into unwanted insurance because of low rates.”

The key, she says, is affordability and full coverage.

“Junk insurance seems affordable” and the coverage is excellent, she said – “until you get sick”.