Health Insurance Coverage and Access to Care Among African Americans
African Americans comprise 13% of the U.S. population. As a group, their health status continues to lag behind that of whites. For example, the African American infant mortality rate is more than double that of whites and African Americans die from diabetes at more than three times the rate of whites. Although many factors account for health status differences, access to health insurance coverage and appropriate health services could reduce many of these disparities.
Health Insurance Coverage
Nationally, 56% of African Americans have private health insurance coverage. Medicaid covers an additional 21%, but almost one quarter (23%) are uninsured (Fig. 1). The uninsured rate for African Americans is more than one and a half times the rate for white Americans, largely because of gaps in employer-based coverage. Although over 8 in 10 African Americans are in working families, employersponsored health insurance among African Americans remains substantially lower than that of whites (53% vs. 73%), even in a strong economy that has helped to improve access to job-based health benefits for some.
People of Health Insurance
Many factors disadvantage African Americans in the workplace, including less education, lower pay (even when similarly educated), and discriminatory practices. As a result, a wide income gap exists between African Americans and whites, with African Americans three times as likely as whites to live in poverty (the federal poverty level for a family of three was $12,802 in 1997). Half of all African Americans have family incomes less than 200% of the poverty level.
African Americans job-based coverage across Insurance
While lower family income translates to a lower likelihood of having employer-based health coverage, African Americans are less likely to have job-based coverage at all income levels compared to whites. Lower rates of employer-based coverage result even though African Americans are more likely than other groups to work in large businesses that typically offer health benefits. In fact, African Americans are substantially less likely than whites to receive job-based coverage across all firm sizes and industries.
Medicaid covers half of African Americans
Medicaid provides an important safety net for one in five African Americans, underscoring the role that Medicaid plays for low-income families with children. Medicaid covers half of African Americans with incomes below poverty and 17% of those between 100 and 199% of poverty. However, Medicaid’s protection is incomplete leaving 30% of African Americans below 200% of poverty uninsured.