As the Affordable Care Act increased access to subsidized health plans last year, fewer adults went uninsured but disparities persisted in their access to insurance and medical care.
Fewer adults ages 18 to 64 were uninsured in 2014 compared with the 2013, regardless of race or ethnicity, the Centers for Disease Control and Prevention said in a new report. However, the drop in the number of uninsured did not erase the gaps between Hispanic and black adults—who were most likely to be uninsured—and white and Asian adults.
Roughly one-third (34.1%) of Hispanic adults were uninsured in 2014 compared with 41.1% the prior year, a significant gain. Hispanic adults also saw improvement across three other measures of access: access to a usual source of care; a visit with a health professional in the last year; and the decision to avoid needed care because of cost. Yet for all but one measure, disparities remained in 2014 for Hispanic adults.
Hispanics remained the most likely to be uninsured in 2014. Last year, 11.5% of white adults were uninsured; 17.6% of black adults were uninsured; and 12.1% of Asian adults were uninsured.
Not all states chose to expand Medicaid under the Affordable Care Act and lawmakers' decision to opt out left an estimated 14.4 million adults ineligible for subsidized health plans under the law, including 3.6 million Hispanics and 2.9 million black adults, an analysis by the Kaiser Family Foundation shows. The uninsured are less likely to get preventive screening or care for chronic disease and have higher mortality rates. Disparities accounted for $309 billion in direct and indirect costs, according to one 2009 estimate by the Joint Center for Political and Economic Studies.
Hispanics were the least likely to have a usual source of medical care in 2013. That did not change in 2014, when 73% of Hispanics had a usual provider. That year, 85.6% of whites had a usual care provider, as did 81.4% of blacks and 82.7% of Asians.
Hispanics were also the least likely to visit or talk to a healthcare professional in the last year in 2014. Seventy percent of Hispanic adults met with a healthcare professional last year. That's compared with 83.6% of whites, 81.3% of blacks and 78.2% of Asians.
Notably, 7.6% of Hispanics reported they did not get needed medical care in 2014 because of the cost. That's a decline from 9.9% the prior year, when Hispanics and black adults were the most likely to skip needed medical care because of cost.
Among black adults, however, there was no statistical change in the percentage of adults who did not get care because of cost from one year to the next—it remained 9.9% in 2014. The figure was 7% among white adults and 3.8% among Asians.