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Affordable Care Act and Health Disparities

Racial and ethnic disparities make one of the primary concerns in health care today. Representatives of minorities usually have worse insurance coverage and lack access to high-quality care, which leads to significant discrepancies in health outcomes. Consequently, there is a need for interventions with the potential to reduce disparities and provide all population groups with equal access to healthcare facilities and insurance. The Patient Protection and Affordable Care Act, frequently shortened to the Affordable Care Act (ACA), is a federal statute that came to power in 2010 and was aimed to improve the situation in health care as a whole and reduce health disparities in particular. The adoption and implementation of ACA principles are considered to have a positive effect on shortening racial and ethnic disparities in health care.

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Presentation of a Cause

Adoption of provisions stated in ACA and reformation of the healthcare system to meet the standards is a cause in this case. One of the aspects of ACA adoption is the improvement of insurance coverage. Thus, numerous studies provide data that prove high uninsurance levels among ethnic minorities. For example, as of 2013, 40.5% of Hispanics and 25.8% of Blacks were uninsured, while only 14.8% of Whites did not have health insurance (Buchmueller et al. 1419). During the second open enrollment period for ACA in 2015, more changes were expected to be observed in such aspects as self-reported insurance coverage and access to care (Sommers et al. 367). Chen et al (141) also focus on the effect that ACA utilization had on health care access for ethnic minorities.

The adoption of ACA was not even throughout the country. Thus, in 2014, only 24 states as well as District Columbia were ready to implement the ACA provisions and support Medicaid expansions (Wherry and Miller 795). Still, the states that accepted ACA, were expected to experience improvements in health insurance coverage and the related indicators thus approaching the reduction of health disparities as a whole and ethnic ones in particular.

Description of the Effect

After most of the ACA provisions went into effect during 2014, the situation with insurance coverage changed. Thus, a slight decrease in the percentage of the uninsured adult population decreased by 7.1 percent for Hispanics, 5.1 percent for blacks, and 3 percent for Whites (Buchmueller et al. 1419). Moreover, the increase in coverage was more evident in states that expanded Medicaid programs. Sommers et al. (369) conducted a study of pre-and post-ACA outcomes. The survey covered more than 505 thousand adult participants, who showed worsening for all outcomes in pre-ACA trends. At the same time, after the second open enrollment period for ACA already by the first quarter of 2015, the following improvements were recorded. Thus, the proportion of uninsured decreased by 7.9 percent, of those who lacked a personal physician by 3.5 percent; those who lacked easy access to medicine by 2.4 percent; who were unable to afford care – by 5.5 percent; who reported fair/poor health – by 3.4 percent (Sommers et al. 369). It should be mentioned that changes in coverage were the most meaningful among minorities. For example, the number of individuals shortened most of all among Latino adults. Medicaid expansion should also be mentioned as a decisive factor, which resulted in the shortening of uninsured individuals among low-income adults.

The study by Wherry and Miller (799) provides evidence of the increase in insurance coverage as a result of ACA adoption. Positive changes were observed in individuals with private or Medicaid insurance as well as among the uninsured. The general rate of health insurance improved. Also, the growth was recorded in visits to specialists in general practice and hospitalizations. Frean et al. (74) also support the idea that Medicaid expansion within the adoption of ACA has a positive impact on insurance coverage. Thus, research revealed an increase of 3.3 percentage points in Medicaid coverage within the research sample (Frean et al. 75). Blumenthal et al. (2452) admit the general positive effect on the health care delivery system. Despite the criticism of the reformative potential of ACA, it stimulated much effort in addressing the problems of health care delivery to all population groups. It is characterized by incentives to reduce Medicare readmissions, hospital-acquired conditions, introduce pay-for-value programs for hospitals and physicians, and bundled payments (Blumenthal et al. 2454). A significant contribution was made in the organization of health care delivery due to the encouragement of accountable care organizations and primary care transformation.

Social work is a separate aspect that should be considered in the discussion of ACA effects. Andrews et al. (67) claim that experience of social work has the potential to empower interventions executed within ACA and thus contribute to the improvement of the population health. Moreover, ACA empowers social workers in such areas as patient navigation, care coordination, and behavioral health treatment. All those aspects directly influence health outcomes and can reduce health disparities.

On the whole, ACA provisions can be treated as triggers for further positive changes in health care delivery and availability. Future reduction of health disparities can be provided by federal agencies and professional organizations such as the American Public Health Association (Adepoju et al. 665). Thus, the ACA effect can be considered a contribution to the elimination of the disparity gap in health care. ACA stimulated the most significant change in American health policy. The estimated increase in coverage with health insurance is expected to reach 25 million more American citizens by 2019 (Shaw et al. 75). ACA has already limited discriminatory insurance practices and made coverage more affordable. Moreover, ACA introduces the first National Prevention Strategy as well as supports public health programs. In addition to health-related, ACA has certain economic implications. Thus, research on health insurance and the labor market revealed that an increase in parental insurance coverage of young adults was observed as a result of ACA provisions’ implementation (Antwi et al. 1).

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On the whole, ACA is a law that contributes to more effective collaboration between the American health-care and public health systems. Previously, these systems functioned separately, which resulted in many health disparities that harm the health of the nation as a whole. At present, a high level of interaction already influences the advancement of the health of the US population. Generally speaking, the Patient Protection and Affordable Care Act has the potential to advance different fields of health care. Still, its greatest contribution is to reducing health disparities on the whole and racial and ethnic disparities in particular. Consequently, healthcare facilities, as well as other health-related organizations, should accept the provisions of ACA to enhance the quality of care and contribute to equal access to care for diverse populations.

Works Cited

Adepoju, Omolola, Michael Preston, and Gilbert Gonzales. “Health Care Disparities innteh Post-Affordable Care Act Era.” American Journal of Public Health, vol. 105, 2015, pp. 665-667.

Andrews, Christina, et al. “Social Work and Implementation of the Affordable Care Act.” Health and Social Work, vol. 38, no. 2, 2013, pp. 67-71.

Antwi, Yaa Akosa, Asako Moriya, and Kosali Simon. “Access to Health Insurance and the Use of Inpatient Medical Care: Evidence from the Affordable Care Act Young Adult Mandate.” Journal of Health Economics, vol. 5, no. 4, 2013, pp. 1-28.

Blumenthal, David, Melinda Abrams, and Rachel Nuzum. “The Affordable Care Act at 5 Years.” The New England Journal of Medicine, vol. 372, no. 25, 2015, pp. 2451-2859.

Buchmueller, Thomas et al. “Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage.” American Journal of Public Health, vol. 106:8, Pp. 1416-1421

Chen, Jie, et al. “Racial and Ethnic Disparities in Health Care Access and Utilization under the Affordable Care Act.” Medical Care, vol. 54, no. 2, 2016, pp. 140-146.

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Frean, Molly, Jonathan Gruber, and Benjamin Sommers. “Premium Subsidies, the Mandate, and Medicaid Expansion: Coverage Effects of the Affordable Care Act.” Journal of Health Economics, vol. 53, 2017, pp. 72-86.

Shaw, Frederic, et al. “The Patient Protection and Affordable Care Act: Opportunities for Prevention and Public Health.” The Lancet, vol. 384, no. 9937, 2014, pp. 75-82.

Sommers, Benjamin D. et al. “Changes in Self-Reported Insurance Coverage, Access To Care, And Health Under The Affordable Care Act.” JAMA, vol. 314, no. 4, 2015, pp. 366-374.

Wherry, Laura R., and Sarah Miller. “Early Coverage, Access, Utilization, and Health Effects Associated With the Affordable Care Act Medicaid Expansions.” Annals of Internal Medicine, vol. 164, no. 12, 2016, pp. 795-803.

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