Oct 25, 2022 - Health

HHS reports significant increase in Black, Latino ACA health care enrollment since 2020

Photo of Xavier Becerra speaking from a podium with the HHS seal behind him

U.S. Secretary of Health and Human Services Xavier Becerra speaks during a news conference on June 28, 2022 in Washington, D.C. Photo: Alex Wong via Getty Images

Black and Latino Americans saw surges in enrollment in the federal government's health care marketplace between 2020 and 2022, according to a new report released by the Department of Health and Human Services.

Why it matters: Black and Latino communities have historically had higher uninsured rates despite facing greater risks of worse health outcomes.

Details: The report, which analyzed race and ethnicity for HealthCare.gov enrollment data from 2015 to 2022, found that all racial groups other than multiracial people experienced boosts in enrollment between 2020 and 2022.

  • Latino enrollees saw a 53% increase.
  • Black enrollees saw a 49% increase.
  • American Indian and Alaska Native enrollees saw a 32% increase.
  • White enrollees saw an 11% increase.
  • Asian American, Native Hawaiian and Pacific Islander enrollees saw a 6% increase.

What they're saying: "[E]nrollment growth of Black and Latino populations exceeded all other groups during this time period and grew by nearly 40 percent for both groups between 2021 and 2022, building on more modest gains that occurred between 2020 and 2021," the report states.

  • "It's the combined effort of more outreach and more affordable coverage that has led to a game changer here in these communities," Ben Sommers, one of the lead researchers, told Axios.
  • When the Affordable Care Act was first implemented, data indicated that Black and Hispanic populations were not enrolling at high rates, in part due to historical distrust of the federal government, according to Nadereh Pourat, the associate director of the UCLA Center for Health Policy Research.
  • "Sustainability always is important," Pourat added. "So these lessons about what kind of approach works, how you talk to people, what messages you should give, who should give the message ... They should be embedded into [the federal government's] routine" to ensure all communities benefit.
  • The report's findings also highlight the continuing need for more comprehensive data collection on race and ethnicity — which remains incomplete and inconsistent — to better address health inequities.

The big picture: ACA enrollment underwent a boost in recent years in part because of COVID-driven job losses.

Worth noting: Because enrollees are not required to report their race, researchers used validated imputation techniques for missing data, which involved inputting values for missing race and ethnicity information based on an Improved First Name Surname Geocoding method that was developed by the nonprofit global policy think tank RAND Corporation.

  • The report did specify that the method has high overall predictive accuracy but is less predictive for American Indian, Alaska Native and multiracial individuals.
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