While African Americans account for 2.8 million of the more than 20 million people who gained health insurance coverage under the Affordable Care Act, their uninsured rate remains well above that of white Americans (9.7 percent vs. 5.4 percent), a report from the Century Foundation finds. The report, Racism, Inequality, and Health Care for African Americans (HTML or PDF, 14 pages), found that high costs continue to limit access to health care for African-American families, who spend nearly 20 percent of household income on healthcare premiums and out-of-pocket costs, compared with a national average of 11 percent. And because African Americans tend to be poorer on average than other demographic groups, they are disproportionately affected by the lack of Medicaid expansion in fourteen states — including Texas, Florida, and Georgia, home to the largest numbers of uninsured African Americans. Social determinants of health such as poverty, income inequality, wealth inequality, food insecurity, and the lack of safe, affordable housing have important implications for African Americans' health risks and outcomes and ability to obtain insurance, while racism itself also contributes to health disparities. In order to ensure meaningful insurance coverage and access to quality health care for African Americans, the report concludes, the healthcare system must be transformed to better address such factors.
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