The Affordable Care Act: Reducing Inequality in Healthcare

The Patient Protection and Affordable Care Act (ACA) and its modifications make up the coordinated healthcare reform law. The Affordable Care Act (ACA) focuses on health insurance coverage, treatment expenditures, and preventative care. In 2010, when the legislation was implemented, about 50 million Americans lacked health insurance (Kominski et al., 2017). It essentially employs strategies such as boosting Medicaid access to enhance health insurance coverage. The law primarily targets marginalized people and families since they form a huge proportion of uninsured individuals.

The health care sector in the United States (US) is defined by significant and ongoing racial inequities in access to treatment as well as insurance coverage for medical expenses. When the ACA was first put into effect in 2010, the rate of uninsurance among black individuals was around 70 % higher than that of white people (Buchmueller & Levy, 2020). In addition, the proportion of uninsured for Hispanics of any race was approximately three times that of whites (Buchmueller & Levy, 2020). These gaps in insurance coverage led to racial minority groups’ poor access to care and lower health outcomes.

By introducing new and affordable insurance alternatives for America’s marginalized population, the ACA has the potential to minimize inequities and enhance access and health care among these populations. The expansion of coverage under the ACA has made it simpler for individuals to access health care. Low-income adults have benefitted substantially from the law’s insurance subsidies and expansion of Medicaid eligibility. Prior to 2013, Hispanic and Black individuals reported much greater cost-related barriers to care than white adults (Baumgartner et al., 2020). After the 2014 significant coverage expansions under the ACA, they enjoyed the greatest overall access gains (Baumgartner et al., 2020). According to Baumgartner et al. (2020), in 2013, 23 percent of adult blacks reported postponing treatment due to expense, compared to 17.6 percent in 2018. Hispanic adult access difficulties decreased from 27.8 percent to 21.2 percent, while white adult accessibility problems decreased from 15.1 percent to 12.9 percent (Baumgartner et al., 2020). Consequently, the cost-related access concerns among white, black, and Hispanic adults have decreased.

The Affordable Care Act permitted states to extend Medicaid eligibility, with the national government covering the majority of the new costs. In certain research, insurance coverage and access metrics for persons in two groups were assessed (Baumgartner et al., 2020). It comprised both those whose Medicaid eligibility had been increased and the people whose eligibility had not been expanded. According to Baumgartner et al. (2020), the 31 states that increased the scope of their programs started out with a more stable starting point and reduced racial imbalances. Between the years 2013 and 2018, the rates of uninsurance for black Americans, Hispanics, and whites declined in states that expanded Medicaid as well as those that did not expand Medicaid (Baumgartner et al., 2020). In addition, gaps in coverage between whites, Hispanics, and blacks decreased in both groups of states during the same period. Regarding coverage increases, those residing in states that expanded Medicaid gained the most. As a result of this advancement, blacks in expansion regions are now more certain to have health insurance than the whites in non-expansion states.

Profound discrepancies in insurance coverage, health status, and access to care exist in the United States. Interestingly, the Affordable Care Act involves health insurance coverage, the cost of health treatment, and preventative care. To promote access to health insurance, it largely employs strategies such as extending Medicaid eligibility. Since the implementation of the Affordable Care Act, insurance coverage has increased in general, and gaps in access and coverage by race have steadily decreased. Nonetheless, insurance coverage is not universal, and significant inequities still persist in the United States.


Baumgartner, J., Collins, S., Radley, D., & Hayes, S. (2020). How the Affordable Care Act (ACA) Has Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Health Care, 2013‐18. Health Services Research, 55, 56-57.

Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in health insurance coverage and access to care: An examination of how the insurance coverage expansions of the Affordable Care Act have affected disparities related to race and ethnicity. Health Affairs, 39(3), 395-402.

Kominski, G. F., Nonzee, N. J., & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38, 489-505. Web.

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LawBirdie. (2023) 'The Affordable Care Act: Reducing Inequality in Healthcare'. 1 August.


LawBirdie. 2023. "The Affordable Care Act: Reducing Inequality in Healthcare." August 1, 2023.

1. LawBirdie. "The Affordable Care Act: Reducing Inequality in Healthcare." August 1, 2023.


LawBirdie. "The Affordable Care Act: Reducing Inequality in Healthcare." August 1, 2023.