Minorities disproportionately represented in health care 'coverage gap'

McClatchy Washington BureauDecember 17, 2013 

US NEWS HEALTHCARE 6 RA

Agent John Ryan helps a client from another county with his health care concerns at the BlueCross BlueShield of N.C. Triangle Sales Center in Morrisville, North Carolina, on Tuesday, October 1, 2013.

COREY LOWENSTEIN — Raleigh News & Observer/MCT

New data from the Kaiser Family Foundation shows that minorities will make up 53 percent of the estimated 4.8 million low-income Americans who will fall into the "coverage gap," leaving them without viable options to obtain health insurance next year.

In the 25 states that won't expand eligibility for the Medicaid program, many adults earn too much to qualify for Medicaid, but not enough to qualify for tax credits that would help them purchase marketplace insurance.
That puts them into the bureaucratic no-man's land known as the "coverage gap."
According to Kaiser, minorities makeup about 2.6 million of people in the gap, 27 percent of whom are black.
Hispanics account for 21 percent, while 5 percent are from other races. Whites account for 47 percent of people in the gap.
Additional demographic breakdowns show 76 percent of those in the gap are adults without dependent children, 60 percent come from a working family and while 49 percent are women.
States with the highest numbers of uninsured residents account for most of the people in the coverage gap.
For example, 34 percent of the 2.2 million whites in the gap reside in Florida, Texas and Pennsylvania. While 43 percent of the 1.3 million black adults in the gap hail from Florida, Georgia and Texas. 
While Texas alone accounts for a whopping 59 percent of Hispanics in the gap followed by another 20 percent in Florida.
While the legislative, judicial and executive branches all had a hand in creating the
coverage gap, it was not done by design. Rather the gap was an unintended consequence of the 2012 Supreme Court decision that upheld the Affordable Care Act.
The health law was supposed to provide health insurance for most Americans next year by expanding Medicaid in all states to people earning up to 138 percent of the federal poverty level. That’s about $15,900 for an individual in 2013, or nearly $32,500 for a family of four.

Tax credits would then go to other low- and middle-income people to help them buy coverage on the insurance marketplaces.

If the Medicaid expansion was implemented in every state as originally planned, an estimated 22.3 million Americans likely would have gained coverage next year, according to the Urban Institute, a nonpartisan social and economic policy think tank.

But when the Supreme Court ruled that states could opt out of the expansion, Republican-led states took advantage. Rather than expand their Medicaid programs, most kept their programs as is – open mainly to the poorest of the poor.

For a state-by-state look at who's in the coverage gap, go to these Kaiser links: 

Characteristics of Poor Uninsured Adults who Fall into the Coverage Gap -  http://kff.org/health-reform/issue-brief/characteristics-of-poor-uninsured-adults-who-fall-into-the-coverage-gap

 

The Impact of the Coverage Gap in States Not Expanding Medicaid Eligibility by Race and Ethnicity -

http://kff.org/disparities-policy/issue-brief/the-impact-of-the-coverage-gap-in-states-not-expanding-medicaid-by-race-and-ethnicity

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