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Addressing Health Inequities by Closing the Coverage Gap

January 18, 2022 by Hannah Robinson

By Abby Carter Emanuelson, Grassroots Consultant, Care4Carolina

During a speech in Chicago at the annual meeting of the Medical Committee for Human Rights, Dr. Martin Luther King linked the quest for equality to health care, saying: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

All too often, this injustice comes down to affordability and specifically being priced out of the health insurance market. In the early 2000s, I worked with members of the North Carolina General Assembly to make health insurance more affordable for people with costly health conditions, like multiple sclerosis, cancer and heart disease, to be able to purchase affordable health insurance.  Establishing a high-risk insurance pool was one approach to addressing affordability – but once the Affordable Care Act was signed into law – more comprehensive solution was available to all – namely preventing insurers from including the pre-existing conditions clause and availing the insurance market to individuals and small businesses through healthcare.gov.

In December, a record number of Americans signed up for health insurance through healthcare.gov due to improvements made by Congress and the Biden Administration.  However, millions of Americans remain in the coverage gap, including approximately 600,000 North Carolinians, because states like North Carolina have NOT expanded coverage through Medicaid.

And unfortunately, due to systemic injustices as referenced by Dr. King, people of color face long standing disparities in healthcare coverage — contributing to greater barriers to accessing health care.  American Indian or Alaska Native (AIAN) and Hispanic populations had uninsured rates greater than 20%.  

In September 2020, KFF reported their findings from an extensive literature review on how expansion has affected racial disparities in health coverage, access to care, health outcomes, and economic outcomes.  Two-thirds of the studies on disparities in health coverage “helped narrow but not eliminate racial/ethnic disparities.  Notably, the studies found that Black and Hispanic improved cancer correlated with “decreased coverage disparities.”

The North Carolina General Assembly again has the opportunity to expand coverage, and ultimately care, to more North Carolinians by closing the health insurance coverage gap.  Expanding access to coverage would make us a more humane society.

Category iconUpdates Tag iconCoverage Gap,  Health Equity

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