Black Folks Are Key to Obamacare’s Success

The first lady is aggressively touting the Affordable Care Act with black voters—here’s why.

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Over the holidays, first lady Michelle Obama took to the airways to promote the Affordable Care Act, aka Obamacare, on the Rev. Al Sharpton’s radio show, Joe Madison’s radio broadcast and in other outlets with a large black audience, as well as with a group of mothers who were invited to the White House.

Before that, she had mostly steered clear of policy issues related to the ACA, so why is the first lady now going on the offensive over her husband’s controversial health care plan? Well, not only does the public think highly of her—she routinely polls as one of the most popular figures in the country—but African Americans are a key constituency for the Obama administration, whose signature health care legislation has gained ground in recent weeks but still lags in its numerical targets.

Simply put, if Obamacare is going to work, black folks need to be on board. Here’s why:

We’re Disproportionately Sick

There’s no easy way to say this, but from asthma to diabetes to HIV, African Americans are more likely than the population at large to have a major illness. That makes Obamacare particularly important for us. We can no longer be rejected for having a pre-existing medical condition. We’ll also benefit from the preventive care, vaccines, disease screenings, examinations, women’s health coverage and other essential benefits that Obamacare requires health insurers to offer—benefits that can help us ward off disease, manage existing illnesses, care for children and keep ourselves out of the emergency room.

We’re Disproportionately Un- or Underinsured

One in 4 black Americans under age 65 lacks health insurance, compared with 15 percent of whites and 33 percent of Latinos, who are least likely to have insurance. Of course, being uninsured can contribute to poor health outcomes; it also causes many of us to run up medical debt. A 2008 survey of low- and middle-income Americans found that 55 percent of African Americans were carrying medical debt—an average of $1,900—to cover out-of-pocket expenses they couldn’t afford.

Adding insult to injury, to try to control medical costs, more than one-third of the black folks surveyed didn’t go to the doctor when they had a health problem, and 30 percent skipped a medical test, treatment or follow-up session—illustrating the vicious circle between being uninsured and being in poor health.

We’re More Likely to Be Among the Working Poor

The term “working poor” (pdf) refers to Americans who grind for more than 27 weeks a year and yet make less than the federal poverty guidelines. And more than a fair share of us can be found among the working adults who aren’t officially considered poor, yet don’t earn enough to make ends meet: roughly $16,000 a year for a single person or $32,500 for a family of four, a group that typically goes uninsured.

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