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The uninsured rate for Black, Hispanic, Asian and Native American people plummeted between 2010 and 2022 as more patients obtained health insurance from the Affordable Care Act's marketplaces, Medicaid and employer plans, according to a report released Friday by the Department of Health and Human Services.
The uninsured rate for black Americans fell from about 21% to just under 11%, and the uninsured rate for Hispanic Americans fell even further, from almost 33% to 18%, the uninsured rate for Asian Americans fell from about 17% to just over 6%, and the uninsured rate for Native Americans fell from over 32% to about 20%.
White House domestic policy adviser Neera Tanden said the report is the first comprehensive data to disaggregate marketplace premium rates by race and ethnicity. “This is something we wanted to understand,” she said.
The decline has significantly narrowed disparities between ethnic groups: For example, the uninsured rate for Black Americans was about 8 percentage points higher than that of white Americans in 2010, but was only 4 percentage points higher by 2022.
The data shows the broader impact of the Affordable Care Act, the landmark law signed by President Obama in 2010 that created new state and federal insurance marketplaces and expanded Medicaid to millions of adults. The national uninsured rate has continued to fall in recent years, hitting an all-time low in early 2023.
Behind the numbers: White House officials primarily credited the increased subsidies to Marketplace plans.
Tanden attributed the recent expansion of coverage in part to federal subsidies expanded as part of the 2021 pandemic relief package that allowed Americans to buy marketplace plans with lower premiums. The subsidies were later extended through 2025.
According to federal data released with the report, the number of Black and Hispanic American Marketplace enrollments nearly doubled from 2020 to 2023. The Biden administration has also highlighted that 2024 will see the highest number of Marketplace enrollments ever, including an estimated 5 million Hispanic Americans, 2 million Black Americans, 2.5 million Asian Americans and 200,000 Native Americans.
Many of those who stayed insured in recent years were low-income Americans on Medicaid who benefited from a provision in the 2020 pandemic relief package that required states to keep people enrolled in the program without regular eligibility checks. The policy expired in April 2023.
What critics say: Opponents of subsidies argue that they are an expensive way to provide mediocre health insurance.
Conservative critics of the subsidies say the amount of the subsidies — $64 billion over a three-year extension, according to the Congressional Budget Office — is prohibitive given the quality of the marketplace plans, which can include deductibles and co-payments that could be too high for middle-class Americans.
President Biden has highlighted the subsidy expansion as part of his health care policy agenda, but the subsidy could come under attack if former President Donald J. Trump wins the presidential election in November. Trump or a Republican-controlled Congress could allow the subsidy expansion to expire, which would mean higher premiums.
What's next: The Biden administration is making significant investments to help more people enroll in Marketplace plans.
The Centers for Medicare and Medicaid Services also announced $500 million over five years to expand the workforce of insurance “navigators,” groups that help Americans navigate the insurance marketplace, after funding for such groups was reduced under the Trump administration.
Federal officials said the $100 million being pumped into the program in its first year marks the largest single-year investment ever.