Summary: 

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As a result of poor and inequitable social determinants of health and disparate access to care and services, communities of color experience higher rates of chronic diseases, death and infant mortality, than their white peers. These conditions include cardiovascular disease, obesity, diabetes, cancer and HIV/AIDS, among others. Access to care can vary according to geographic location, race/ethnicity, culture, and socioeconomic status. Healthcare access has improved with Medicaid expansion across 39 states and the District of Columbia, with over 12 million uninsured adults having received health insurance coverage. Expansion has not only improved access to care but also racial and ethnic health equity, as displayed by reductions in chronic disease burden in expansion states. 

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However, racial health disparities persist, and, amid the COVID-19 pandemic, these disparities have been exacerbated. Higher rates of underlying health conditions and overrepresentation in low-wage, higher-risk jobs within communities of color, has driven greater prevalence of COVID-19 related deaths within these populations. Thus, Medicaid spending and enrollment is projected to be higher than pre-pandemic estimates. Furthermore, persons with comorbidities face new challenges of disease management and health care and service access, especially when factoring in technology barriers. Impacts to care utilization, including lower virtual visits, child vaccinations, and important in-person health screenings and procedures, could lead to widened gaps in health equity for those most vulnerable.

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The pandemic has catalyzed a national conversation, spurred collaborations, and launched new initiatives with missions to address not only the effects of COVID-19 on communities of color but also the root social health inequities that paved the way for such outcomes. Medicaid can be at the forefront of making history in the fight to address health disparities in care and outcomes. As the insurance provider to those disproportionately impacted by the pandemic, Medicaid is uniquely positioned to lead sustainable change that shifts the trajectory of health inequity in the United States.