Thursday June 25, the Supreme Court voted 6-3 to uphold the Affordable Care Act also known as Obamacare, which creates the question of how will it continue to affect African Americans today and in the future?
As of April 19, 2014, there were approximately 318,077 Pennsylvanians receiving healthcare coverage through the exchange marketplace of the ACA. According to federal numbers extrapolated from surveys, 28,965 were African American or roughly 11 percent.
The nationwide number for African Americans was 789,498 and about 14 percent of the national number, on par with the 13 percent of the population that is African American.
When the law went into effect in January 2014, then Gov. Tom Corbett refused to create a state exchange for subsidies. Had the SCOTUS voted down the subsidies provision, Press Secretary for Governor Tom Wolf, Jeff Sheridan, was ready with a plan B.
“The governor had put into place a contingency plan in the event the Supreme Court ruled that people are not eligible for subsidies so that the state would set up its own marketplace,” said Sheridan.
“The parties that brought the lawsuit were trying to say that the law explicitly states that you can only receive subsidies through a state based marketplace but people receiving subsidies through the federal marketplace were also receiving subsidies.”
According to the National Cancer Institute, African Americans have the highest mortality rate of any racial and ethnic group for cancer. If that wasn’t dire enough, if you are a Black woman, even though you are actually 10 percent less likely to develop cancer, you are 40 percent more likely to die from the disease. Likewise, although African American adults are 40 percent more likely to have high blood pressure, they are 18 percent less likely than their non-Hispanic White counterparts to have their blood pressure under control. And according to the CDC, African Americans are twice as likely to be diagnosed with diabetes.
Sixty-two percent of uninsured African Americans have incomes at or below the Medicaid expansion limit of 138 percent of federal poverty level. However, nearly six in 10 uninsured African Americans with incomes below the Medicaid expansion limit reside in red states whose governors have no plans to expand Medicaid. Consequently, African-Americans are 55 percent more likely to be uninsured than White Americans. In 2013, the proportion of African Americans who were uninsured was 17 percent according to the Kaiser Family Foundation.
According to the Department of Health and Human Services, 7.8 million African Americans with private insurance now have access to expanded preventive services with no cost-sharing. 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, HPV testing, counseling, mammograms, screenings for cervical cancer, prenatal care, well-woman visits and other services.
About 10.4 million African Americans, including 3.9 million adult African American women, no longer have lifetime or annual limits on their health insurance coverage thanks to the Affordable Care Act.
No one from the Gateway Medical Society, Pittsburgh’s leading non-profit for fighting African American medical disparities, was available for comment. The New Pittsburgh Courier was told by a source who wished to stay anonymous because many doctors work for hospitals, they were reluctant to give their opinion. The NMA (National Medical Association) is the largest and oldest national organization representing African American physicians and their patients in the United States. NMA President Dr. Lawrence L. Sanders Jr. released a statement saying in part: “The Supreme Court’s ruling in King v. Burwell decision today to uphold the constitutionality of the Affordable Care Act is a major victory for millions of Americans who will continue to benefit from this historic legislation.”
It seems the biggest winners in the ACA decision could well be African American doctors.
The health care workforce is more diverse due to a more than doubling of the National Health Service Corps. African American physicians make up about 18 percent of Corps. physicians, a percentage that greatly exceeds their 6 percent share of the national physician workforce.
On the plus side for the African American patient, nearly one of every four patients at a health center is African American and $11 billion in the Affordable Care Act for the nearly 1,300 community health centers has increased the number of patients served by nearly 5 million.
UPMC Health Plan as well as Highmark gave an approving nod to the SCOTUS decision saying that the decision will go a long way toward ensuring that access to affordable coverage continues for all Pennsylvanians and for other individuals and families purchasing products through a federally facilitated marketplace.
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