The Affordable Care Act (ACA) expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL) effectively became a state option following the Supreme Court decision, creating a “coverage gap” for many poor uninsured adults in states that do not expand Medicaid. This brief examines the coverage gap by race and ethnicity.
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On September 8, 2015, the Department of Health and Human Services (HHS) proposed regulations to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the proposed rule and highlights new protections and provisions included in the law and rule . Notably, Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in health care. Moreover, the proposed rule extends the definition of sex discrimination to include discrimination on the basis of gender identity (but does not explicitly include sexual orientation). In addition, the proposed rule establishes regulations related to the provision of language assistance services based on long-standing HHS policy guidance. This brief does not assess the implications of the proposed rule.
This analysis based on data from the 2014 Kaiser Survey of Low-Income Americans examines differences in access to and utilization of care for Black and Hispanic adults compared to White adults among those who are uninsured, enrolled in Medicaid, and privately insured. The findings suggest that gains in health coverage under the ACA will lead to improvements in access to care and utilization for White, Black, and Hispanic adults. They also highlight the importance of increased attention to addressing racial and ethnic disparities in access to and utilization of care among privately insured adults, particularly as the privately insured population becomes more diverse as a result of greater enrollment of people of color into private plans through the ACA Marketplaces.
Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S.
Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual’s sexual orientation or gender identity. This issue brief examines population characteristics of the LGBT community including demographics, health challenges such as chronic conditions, HIV/AIDS epidemic and STIs, mental health and substance use, sexual and physical violence, adolescent and young adult health, and access to care and insurance coverage. Additionally, this brief examines the impacts of the Affordable Care Act (ACA), the recent Supreme Court rulings and other policy changes related to same-sex marriage on insurance coverage and access to health care services.
Report Examines the Role of Medicare and the Indian Health Service for American Indians and Alaska Natives
A new report from the Kaiser Family Foundation examines the role of both Medicare and the Indian Health Service (IHS) in providing access to health care for about 650,000 American Indians and Alaska Natives who are age 65 and older or who have permanent disabilities. While Medicare provides important health…
The Role of Medicare and the Indian Health Service for American Indians and Alaska Natives: Health, Access and Coverage
This report examines the role of both Medicare and the Indian Health Service (IHS) in providing access to health care for about 650,000 American Indians and Alaska Natives who are age 65 and older or who have permanent disabilities. While Medicare provides important health care coverage for most in this group, its relatively high cost-sharing and gaps in benefits can be problematic for American Indians and Alaska Native Medicare beneficiaries who do not have additional supplemental coverage or who cannot access IHS providers.
The Peterson Center on Healthcare and the Kaiser Family Foundation have partnered to monitor how well the U.S. healthcare system is performing in terms of quality and cost. The Peterson-Kaiser Health System Tracker is an online hub providing comprehensive data on how the system is performing on critical quality and cost…
An updated issue brief from the Kaiser Family Foundation gives a detailed profile of health concerns for lesbian, gay, bisexual and transgender individuals, offers the latest demographic data, and discusses the impact of recent changes in state and federal policies on health coverage, including the Affordable Care Act and same-sex…