The Affordable Care Act and African Americans

The Affordable Care Act is making health insurance coverage more affordable and accessible for millions of Americans. For African Americans, like other racial and ethnic minorities, the law addresses inequities and increases access to quality, affordable health coverage.  The Affordable Care Act invests in prevention and wellness, and gives individuals and families more control over their care.

African Americans suffer from higher rates of a range of illnesses as compared to the general population. African Americans have the highest mortality rate of any racial and ethnic group for all cancers combined and for most major cancers individually, including stomach, liver, prostate, and colon cancers1. Even though the rate of breast cancer incidence is 10 percent lower among African American women, they are 40 percent more likely to die from the disease. 7 Earlier screening and detection for African American women could help reduce this death rate. Although African American adults are 40 percent more likely to have high blood pressure2, they are 18 percent less likely than their non-Hispanic White counterparts to have their blood pressure under control3. In addition, black adults are less likely than non-Hispanic white adults to have received the flu vaccine in the past year.4 African American adults are also twice as likely to be diagnosed with diabetes5. The infant mortality rate among African Americans is 2.3 times that of non-Hispanic whites; black infants are four times more likely than non-Hispanic white infants to die due to complications related to low birthweight6.  

At the same time, African-Americans are 55 percent more likely to be uninsured than white Americans.  

Expanding opportunities for coverage, and providing no-cost screenings and quality disease management to patients, can improve health outcomes for African Americans. 

Through the Health Insurance Marketplace, 6.8 million uninsured African Americans have new opportunities for affordable health insurance coverage.  Young adults ages 18 to 35 account for nearly half (3.2 million; 47 percent) of African Americans who are uninsured and may be eligible for the Marketplace, but only 30 percent of the eligible African American population overall.

Through the Marketplace, consumers may be eligible for free or low cost coverage, or advance premium tax credits that lower monthly premiums right away. Individuals with higher incomes (up to 400 percent of the federal poverty level, or $94,200 for a family of four) will be eligible for premium tax credits to purchase coverage from the Marketplace.  And states have new opportunities to expand Medicaid coverage to include Americans with family incomes at or below 133 percent of the federal poverty level (generally $31,322 for a family of four in 2013). This expansion includes adults without dependent children living at home. These adults have not previously been eligible in most states.

Six in ten uninsured African Americans (4.2 million) may be eligible for premium tax credits in the Marketplace (2.2 million), or Medicaid or the Children’s Health Insurance Program (CHIP) (2.0 million).  If all states took advantage of new opportunities to expand Medicaid coverage, 95 percent of eligible uninsured African Americans might qualify for Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits to help with the cost of premiums.

Private plans in the Marketplace are required to cover 10 essential health benefit categories, including maternity and newborn care.  Starting in 2014, over 390,000 African American women who currently buy coverage in the individual market will gain maternity coverage, as part of the Affordable Care Act’s requirement for plans to cover essential health benefits.

Moreover, millions of African Americans across the country are already benefiting from the stronger coverage and consumer protections made possible by the Affordable Care Act:

  • 7.3 million African Americans with private insurance now have access to expanded preventive services with no cost sharing. This includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.
  • An estimated 5.1 million African American women with private health insurance now have guaranteed access to women’s preventive services without cost sharing. These services include well-woman visits, HPV testing, counseling services, breastfeeding support, mammograms and screenings for cervical cancer, prenatal care, and other services.
  • The 4.5 million elderly and disabled African Americans who receive health coverage from Medicare also have access to many preventive services with no cost-sharing, including annual wellness visits with personalized prevention plans, diabetes and colorectal cancer screening, bone mass measurement and mammograms.  
  • 3.1 million young adults have gained coverage through their parents’ plans.  That includes more than 500,000 young African American adults ages 19 to 26, 230,000 of whom are women. 
  • About 10.4 million African Americans, including 3.9 million adult African American women, no longer have lifetime limits on their health insurance plans thanks to the Affordable Care Act.
  • The health care workforce will be more diverse due to a near tripling of the National Health Service Corps. African American physicians make up about 17 percent of Corps physicians, a percentage that greatly exceeds their 6 percent share of the national physician workforce.
  • Investments in data collection and research will help us better understand the causes of health care disparities and develop effective programs to eliminate them.
  • Targeted interventions, such as Community Transformation Grants, will promote healthy lifestyles, lower health care costs, and reduce health disparities.
  • Increased funding available to more than 1,100 community health centers will increase the number of patients served. One of every five patients at a health center is African American.


1Source: NCI 2013. Seer Cancer Statistics Review, 1975-2010. Table 1.21.

2Source: CDC 2012. Summary Health Statistics for U.S. Adults: 2011. Table 2.

3Source: 2012 National Healthcare Disparities Report. Table T2_2_1_2-1

4Source: CDC 2012. Health United States, 2011. Table 88.

5Source: CDC 2012. Summary Health Statistics for U.S. Adults: 2011. Table 8.

6Source: CDC 2013. Infant Mortality Statistics from the 2009 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports. Table A.

7Source: NCI 2013. Seer Cancer Statistics Review, 1975-2010. Table 4.19.

Posted on: April 12, 2012

Last updated: December 16, 2013