How the ACA Can Help to Advance Racial and Ethnic Health Equity in Colorado
The Colorado Trust
The ACA, which was signed into law by PresidentObama on March 23, 2010, aims to expand accessto health care, improve the quality of care andcontain health care costs. The law also has thepotential to advance health equity. In this report,health equity is deﬁned as the elimination ofinequalities affecting racial/ethnic populationsso all Coloradans can achieve optimal health.The greatest health disparities
exist alongsocioeconomic lines. High socioeconomic status(SES) is linked to better health, while low SES isclosely correlated with poor health. Because racial/ethnic minorities are disproportionately representedamong low-income populations, they experiencedisparities based on SES.
Racial/ethnic disparities go beyond thosecorrelated with income, however. Controlling forSES, racial/ethnic minorities are less likely than thegeneral population to have insurance and access tohealth care. They also suffer worse health outcomesacross a spectrum of health indicators, includinglife expectancy, infant mortality, rates of chronicdisease and self-reported health status.
Colorado policy leaders can userelevant components of the ACA toaddress the social and economic costsof racial/ethnic health disparities.
Other populations, such as individuals with disabilities and the gay,lesbian, transgender community, also suffer from disparities in health.This paper focuses solely on racial/ethnic health disparities.
Studies show that lack of health insurancenegatively affects the quality of health careservices received by racial/ethnic minorities andthat expanding access to care helps reduce racial/ethnic health disparities.
When coupled with statehealth reform efforts, such as the Colorado HealthCare Affordability Act of 2009, the ACA can providehealth care coverage for up to 500,000 additionalColoradans. ,It is also estimated that up to 90,000small businesses may be eligible for tax credits thatwill help them affordably insure their employees.
Health coverage alone is not sufﬁcient to eliminateracial/ethnic health disparities, however. Evenwhen insurance status is equal across populations,disparities in both quality and access to care persistalong racial/ethnic lines.
Access often is limited byother factors such as cultural and linguistic barriers,lack of transportation or lack of providers in aparticular geographic area.Colorado policy leaders can use relevantcomponents of the ACA to address the social andeconomic costs of racial/ethnic health disparitiesand improve quality of care by making health equitya priority. Such actions would add to Colorado’shistory of pursuing innovative solutions to problemsof access, system inefﬁciencies and high coststhrough legislation ranging from the 2008 Blue RibbonCommission for Healthcare Reform to the passageof the Colorado Health Care Affordability Act.
Racial/ethnic minorities are more likely to be uninsuredor underinsured than their white counterparts. Despiteaccounting for 30 percent of the general population,racial/ethnic minorities make up nearly 42 percent ofthe 829,000 uninsured Coloradans. Twenty-six percentof Colorado’s Hispanic population and 14 percentof the non-Hispanic black population are uninsuredcompared with 13 percent of the non-Hispanicwhite population.
Individuals who lack health careinsurance are less likely to have a usual source of careor visit a primary care provider, and are more likely to utilizethe emergency room, resulting in greater costs to theindividual’s health and to the health care system.
Racial and ethnic minority populations are de
Black or African American
Hispanic or Latino
Native Hawaiian andOther Paciﬁc Islander
American Indian andAlaska Native.