While the ACA repeal affects several of our nation’s most vulnerable populations, including people within the lower/poorer economic strata, those with chronic and pervasive illnesses, and those who are uninsured, a retraction would also mean further injustices toward the health of People of Color in all of these categories.
Racial/ethnic minorities have historically suffered the fate of poorer health outcomes across the lifespan. As a whole, this group experiences higher rates of infant-related complications and mortality, a greater abundance of chronic illness and disability, and have shorter life spans, leading to pervasive health disparities across the nation. The 2014 implementation of Obamacare sought to eradicate much of this disproportion in health by increasing access to care for the uninsured. In its first year, it had eliminated differences in uninsured rates between Black and white children, with the prospect of providing further reductions to preexisting racial health disparities for other groups.
Let’s take a closer look at the discrepant health statuses and health risks for Black and Latinx families.
Impact on Moms and Infants
Even before a baby is born into the world, they are exposed to specific risks that are associated with their mother’s health. Several studies have revealed that since Black and Latina women find themselves at the intersection of two systems of oppression, sexism and racism, they are susceptible to prolonged compounded stress related to race and gender-based discrimination. Chronic stress has the capacity to raise a mother’s cortisone levels and other hormones that can trigger early labor, restrict blood flow to the placenta, and stunt infant growth. The Nation recently reported on a new framework established by Dr. Camara Phyllis Jones, the President of the American Public Health Association, in which she found a connection between U.S. cities where there was more established institutionalized racism and higher infant mortality rates. Access to reproductive care is also an issue that can impact these mothers, which adds a layer of complexity to their maternal health.
With the Obamacare repeal threatening to defund Planned Parenthood, meaning it would significantly cut down on the federal funding that is now allocated toward services at its clinics, Women of Color run the risk of further exacerbation of these maternal health issues and an increased potential for compromised in-utero health. Without that, Black and Latinx babies aren’t awarded a more universal chance at obtaining good health.
Impact on Children and Adolescents
During children’s primary and formative years, they engage in different milestones and growth stages. Youth of Color, in particular, face the threat of racial discrimination that can foster perceptions of injustice and powerlessness during these primary years. These have been noted to contribute to child health outcomes and to disparities, such as incongruities in biological functioning (i.e. immune function), the fostering of psychological distress (i.e. depression), and lower quality in the parent-child relationships. Access to continuous medical and mental health care during these developmental years would help Children of Color in the process of developing a healthy body and a healthy mind.
The Affordable Care Act changed some policies that sought to increase the enrollment of children both in the Medicaid and Children’s Health Insurance Program (CHIP), for those who fall above the federal poverty line. A repeal can derail the progress made in balancing access between Children of Color and white children.
Impact on Young Adults & Adults
There isn’t a viable way to provide an exhaustive list of health conditions that affect Black and Latinx adults, but with the American Health Care Act (AHCA)’s proposed caveat around preexisting conditions, the most prevalent illnesses among racial minorities will be impacted. Among the top chronic conditions are diabetes, cardiovascular issues, asthma, advanced stages of cancer, and the list goes on…
As the AHCA relapses into instituting high insurance policy premiums and loss of coverage for pre-existing conditions, the susceptibility that People of Color have to these conditions will likely increase.
Life expectancy, the expected length of life, for Black individuals in particular is the lowest of any racial group in the U.S, with major disadvantages being centered in the health areas of heart disease, cancer, stroke, and HIV/AIDS. Millions of Americans, including Black and Latinx Americans, rely on subsidized healthcare for their healthcare needs in older age. Although many of these aforementioned conditions are degenerative, their progression can be slowed or even prevented with a comprehensive system of care.
The Congressional Budget Office’s estimate for increased Medicare spending would mean that Black elders who partake in the Medicare program may not afford their healthcare and as a result may not afford their own longevity unless they have sufficient means to cover increased premiums.
Impact on Access to Mental Health Care
With the implementation of Obamacare, the Mental Health Parity Act (2008) was extended to individual health insurance coverage. This meant that all individuals were eligible to receive comparable coverage for both medical and mental health visits.
The ACA repeal jeopardizes the progress that the mental health community has made in improving access to care that is both rooted in the quality of delivery and in the cultural responsiveness of services.
And so, despite the great risk that a repeal of the ACA could impose upon millions of Black and Latinx people, those opposed to breaking down the current system continue to proclaim how much the lives that are implicated in these changes matter.
Black and Latinx Health Matters…
…because these are the racial/ethnic groups that are amongst the most negatively impacted by the potential repeal, which sends a message about who’s health and lives matter least to those at the forefront of the repeal.
…because they exhibit remarkable strength, resilience, and survival despite the push to adhere to westernized healing systems that are constantly in flux, and many times not in their favor.
…and because articles like this one need to be written to remind the U.S. public that Black and Latinx Health Matters.
At every developmental stage in life, Black and Latinx individuals are faced with the risk of adverse health consequences, which makes this repeal the type of issue that those invested in racial equity should take seriously. Why? Because for many racial/ethnic minorities, it’s a matter of life or preventable death. And because a good quality of life and longevity should be everyone’s birthright.
Austin, A. (2015). Obamacare Reduces Racial Disparities in Health Coverage. Retrieved from https://globalpolicysolutions.org/wpcontent/uploads/2015/12/ACA-and-Racial-Disparities.pdf
Carpenter, Z. (2017). Black births matter: In America, black infants are twice as likely as white infants to die before their first birthday, The Nation, 12-16.
Cubanski, J., Neuman, T. Boccuti, C. (2016).What are the implications of repealing the Affordable Care Act for Medicare spending and beneficiaries? Retrieved from http://www.kff.org/health-reform/issue-brief/what-are-the-implications-of-repealing-the-affordable-care-act-for-medicare-spending-and-beneficiaries/
Flores, G. & Tomany-Korman, S. C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children, Pediatrics, 124(3), 999-1000.
LaVeist, T., Gaskin, G., & Richard, P. (2009). The economic burden of health inequalities in the United States, International Journal of Health Services, 41(2), 231-238.
Population Reference Bureau (2002). Racial and ethnic differences in U.S. mortality. Retrieved from http://www.prb.org/Publications/Articles/2002/RacialandEthnicDifferencesinUSMortality.aspx
Sanders-Phillips, K., Settles-Reaves, B., Walker, D., & Brownlow, J. (2009). Social inequality and racial discrimination: Risk factors for health disparities in children of olor, Pediatrics, 124, 176-186.