Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review

Objectives To investigate the impact of the Affordable Care Act's (ACA) Medicaid expansion on African American-white disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes. Design A search of research reports, following the PRISMA-ScR guidelines, identif...

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Published in:BMC public health 2022-08, Vol.22 (1), p.1-1638, Article 1638
Main Authors: Snowden, Lonnie R, Graaf, Genevieve, Keyes, Latocia, Kitchens, Katherine, Ryan, Amanda, Wallace, Neal
Format: Article
Language:English
Subjects:
Adults
Affordable care act
African Americans
Ambulatory care
Demographic aspects
Government programs
Health aspects
Health care
Health care disparities
Health care policy
Health disparities
Health insurance
Health policy
Health services
Insurance policies
Laws, regulations and rules
Low income groups
Medicaid
Medicaid expansion
Medical policy
Patient Protection & Affordable Care Act 2010-US
Poverty
Public health
Race
Racial disparities
Racial identity
Research design
Social aspects
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Summary:Objectives To investigate the impact of the Affordable Care Act's (ACA) Medicaid expansion on African American-white disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes. Design A search of research reports, following the PRISMA-ScR guidelines, identified twenty-six national studies investigating changes in health care disparities between African American and white non-disabled, non-elderly adults before and after ACA Medicaid expansion, comparing states that did and did not expand Medicaid. Analysis examined research design and findings. Results Whether Medicaid eligibility expansion reduced African American-white health coverage disparities remains an open question: Absolute disparities in coverage appear to have declined in expansion states, although exceptions have been reported. African American disparities in health access, treatment, or health outcomes showed little evidence of change for the general population. Conclusions Future research addressing key weaknesses in existing research may help to uncover sources of continuing disparities and clarify the impact of future Medicaid expansion on African American health care disparities. Keywords: Affordable care act, Medicaid expansion, Racial disparities, Health disparities, Health policy
ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-022-14033-8