Content area
Full Text
Disparities in healthcare have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care. (Am J Public Health. 2015;105: S665-S667. doi:10.2105/AJPH.2015.302611)
DISPARITIES IN HEALTH CARE have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. The Affordable Care Act1 (ACA) offers the promise of reducing disparities in health and medicine by promoting access to equitable and more efficient health care. However, nearly 5 years after the ACA was signed into law, researchers are still finding a wide chasm in health care access, quality, and outcomes. An expert panel organized by the Disparities Interest Group at the 2014 AcademyHealth Annual Research Meeting, provided areas of interest to consider when addressing disparities. Our policy brief builds on some of the topic areas presented at the interest group meeting. We discuss the role of (1) differential access to health insurance, (2) medical homes and accountable care organizations (ACOs), (3) preventive medicine, and (4) cultural competency on health care disparities in the post-ACA era. Although the ACA provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care.
DIFFERENTIAL ACCESS TO HEALTH INSURANCE
Estimates from the Congressional Budget Office suggest that the ACA will expand health insurance coverage to an additional 26 million people by 2024. Following the first open enrollment period, more than 8 million people purchased private health plans through federal and state-based marketplaces, and an additional 6.7 million people enrolled in Medicaid, the publicly funded insurance program for low-income families and children.2 However, only 27 states and the District of Columbia have decided to expand their Medicaid programs-a decision that leaves up to 4 million low-income adults without health insurance in the nonexpansion states.3
Strikingly, the states not expanding Medicaid are home to the highest uninsured and poverty rates across the country. In Texas and Florida alone, nearly 3...