An analysis of the Affordable Care Act (ACA) revealed racial disparities in health insurance remain persistent.1

“The study aimed to highlight the impact of the ACA on communities of color, specifically with regard to insurance coverage and access to care,” says Jesse Baumgartner, a research associate at The Commonwealth Fund.

Researchers wanted to know how disparities between people of color and white adults may have narrowed since the ACA’s main provisions went into effect. They also were interested in what role Medicaid expansion played in that progress. “We also wanted to report out any racial and ethnic disparities that still remain today,” Baumgartner adds.

One significant finding was insurance coverage for Black adults living in Medicaid expansion states increased dramatically. “It has improved by such a large amount that they are now more likely to be insured than white adults living in non-expansion states,” Baumgartner reports.

However, overall progress regarding racial disparities has largely stalled, and even eroded, since 2016. “Structural racism is built into our current health system. It’s important to detail remaining racial inequities,” Baumgartner says.

This includes health insurance coverage disparities. Also, communities of color can be treated differently by providers even when they do access the system. “This type of data can be used by policymakers and other decision-makers to make the U.S. health system more equitable,” Baumgartner says.


  1. Baumgartner JC, Collins SR, Radley DC, Hayes SL. How the Affordable Care Act has narrowed racial and ethnic disparities in access to health care. The Commonwealth Fund. Jan. 16, 2020.