Key Facts on Health and Health Care by Race and Ethnicity
Section 4: Health Coverage
Despite gains in coverage under the ACA, there remain disparities in coverage by race and ethnicity. Among the total nonelderly population, Hispanics, Blacks, and American Indians and Alaska Natives are significantly more likely than Whites to be uninsured (Exhibit 4.1).
Health coverage among nonelderly adults. Among nonelderly adults, Hispanics and American Indians and Alaska Natives are more than twice as likely as Whites to be uninsured, and the uninsured rate for Blacks is significantly higher than that for Whites (Exhibit 4.2).
Health coverage among children. Uninsured rates are lower for children than adults across racial and ethnic groups, but Hispanic and American Indian and Alaska Native children still are at least twice as likely as White children to be uninsured (Exhibit 4.3).
Racial/ethnic distribution of the uninsured. People of color make up more than half (55%) of the total 32.3 million nonelderly individuals who remained uninsured during 2014. Hispanics alone made up over one-third (34%) of the uninsured (Exhibit 4.4).
Work status and income among the uninsured. Across racial and ethnic groups, most nonelderly uninsured individuals have at least one full-time worker in the family. However, uninsured Hispanics, Blacks, American Indians and Alaska Natives, and Native Hawaiians and Other Pacific Islanders are more likely to have income below poverty compared to Whites (Exhibit 4.5).
Age distribution of the uninsured. Nonelderly uninsured Hispanics, Blacks, and American Indians and Alaska Natives are younger compared to uninsured Whites (Exhibit 4.6). In particular, children make up a higher share of uninsured Hispanics and American Indians and Alaska Natives compared to Whites.
Household type among the uninsured. A larger share of nonelderly uninsured Asians, Hispanics, Blacks, and American Indians and Alaska Natives are in families with children compared to uninsured Whites (Exhibit 4.7). For most of these groups, single adults comprise a smaller share of the uninsured compared to Whites. However, among Blacks, single adults account for a higher share, making up over half (53%) of the uninsured.
Citizenship status among the uninsured. A significantly larger share of nonelderly uninsured Asians, Hispanics, and Blacks are immigrants compared to Whites (Exhibit 4.8). Uninsured Asians have the largest share of immigrants (67%), including 28% who are naturalized citizens. Immigrants account for nearly six in ten (59%) uninsured Hispanics; including 50% who are non-citizens. In addition, nearly one in three (32%) uninsured Native Hawaiians and Other Pacific Islanders is a non-citizen.
Reflecting these differences in characteristics, eligibility for coverage under the ACA among the nonelderly uninsured varies by race and ethnicity. American Indians and Alaska Natives have the highest share of nonelderly uninsured who are eligible for the Medicaid or tax credit subsidies at 70%, followed by Blacks at 55% (Exhibit 4.9). However, Blacks are twice as likely as Whites to falls into the coverage gap that exists in the 19 states that have not expanded Medicaid. Consistent with immigrants accounting for large shares of uninsured Asians and Hispanics, over half of these groups remain ineligible for coverage options.