How Obamacare Will Help Heal Blacks

African Americans who face a health crisis have the most to gain when the bill goes into effect.

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(The Root) -- When Naomi Hollis' job ended last October, she remained remarkably focused. The permanent part-time employee had been with the company for five years, long enough to have health benefits, but those were scheduled to stop at month's end. 

"I was thinking practically," the 46-year-old Birmingham, Ala., resident said. "I tried to get a lot of health stuff done before my insurance ended. I stocked up on medication, let my doctors know what was going on, arranged for some treatment -- discounted or charity -- moving forward."

She was particularly concerned because she knew that once her insurance expired it was unlikely she'd be eligible for new coverage. Hollis -- who was concerned about her health issues becoming public, so she spoke to us using a pseudonym -- has a pre-existing condition: atherosclerosis, which led to three heart attacks when she was in her late 30s and early 40s.

The pre-emptive chats worked in most cases. "The doctors who were willing to work with me said, 'Continue coming. We will find ways to absorb or reduce your copay.' I was charged a Medicaid rate for my cardiologist," she said.

But even the most cooperative doctors can only do so much. Hollis now has been unemployed for nearly a year, and her medications don't come cheap. "I was supposed to take a statin [a drug designed to stabilize arterial plaque and reduce the risk of repeat heart attacks], but that drug is about $60 a month," she said. "I've got $1.40 in my account." She has, with no small amount of trepidation, forgone the statin in favor of paying other bills, such as her mortgage.

Count Hollis among the many African Americans looking forward to Oct. 1 and the start of the open enrollment period for the health care marketplace made possible by the Affordable Care Act.

Even as key elements of the ACA are set to go into effect, House Republicans have threatened to shut down the government this week if the bill moves forward. Early Sunday morning, the House voted to continue funding the government with the caveat that the ACA be delayed for a year. President Barack Obama, who calls the current health care system unacceptable, has vowed to veto any legislation against ACA.

Starting Tuesday, people will get a chance to enroll in the health care marketplace, a one-stop shop where they can compare health insurance options based on benefits, price and quality. The open enrollment period ends March 31, 2014. Every state will have a marketplace, though who runs the marketplaces varies depending on where people live. Some states will run their own marketplace, the federal government will run some marketplaces and some marketplaces will be run by state and federal government partnerships. (To find out about your state's marketplace, click here.)

"In state after state there will be affordable options available for people who have been uninsured," said Dr. J. Nadine Gracia, deputy assistant secretary for minority health and the director of the Office of Minority Health at the Department of Health and Human Services.

African Americans are, not surprisingly, in the worst shape in the pre-ACA system. We are less likely to have health insurance than other Americans. We are less likely to have access to a primary care physician, often relying on the emergency room for medical treatment. And when we do have a doctor, we're less likely to receive quality care.

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