African American and Latinos have historically had greater disparities in coverage and access to health care, but the Affordable Care Act is starting to turn that around, according to a new University of Maryland (UMD) School of Public Health study published in the journal Medical Care.

"Compared to the white counterparts, minorities have lower family income and education, and that influences their health care access and utilization," Jie Chen, assistant professor at the UMB School of Public Health, told HCB News. "The health care resources are lacking in those communities as well [because] a lot of doctors are probably unwilling to move to these areas."

The researchers evaluated data from the 2011-2014 National Health Interview Survey, which asked about health care access and utilization among different groups of adults in the U.S., including non-Latino whites, Latinos, African Americans and others.

They found that since the ACA took effect in 2014, the rates of uninsured African American and Latinos decreased by 7 percent, compared to 3 percent of whites. They also found that those groups were more likely to visit a primary care physician and get timely health care compared to before the ACA coverage started.

The researchers think that the coverage and access for African Americans improved more than for whites because the African Americans are more likely to get insurance coverage through the Health Insurance Marketplace and Medicaid expansion under the ACA.

The ACA allows people with pre-existing conditions to purchase health insurance and there is more price transparency, so patients have a better understanding of the costs, said Chen. The ACA is also putting more of a focus on improving population health.

"If people don't have health care access they can only go to the emergency department like most of minorities do, but now I think a lot of community interventions have been implemented so people can go to primary care doctors to access care when they need it," said Chen.

In the past, hospitals, primary care physicians and specialists worked in silos, but now they are willing to work together to improve population health. "In the long run, especially for minorities who suffer from less health care access, [patients] will benefit more under a more efficiently designed system," said Chen.

There was a slightly smaller decrease in uninsured rates among Latinos because Latino immigrants are more likely to live in states that aren't a part of the Medicaid expansion, said Chen. There is also insufficient outreach in the Latino community for ACA eligibility, subsidies and enrollment.

The researchers concluded that the ACA has the potential to continue reducing disparities in access to health care and health care utilization. Going forward, they are planning on investigating changes in health care quality and health outcomes.

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