What Obamacare Means for Racial Justice

Supporters of the Affordable Care Act in June 2012 (Mark Wilson/Getty Images)
Supporters of the Affordable Care Act in June 2012 (Mark Wilson/Getty Images)

"The forward movement" on Obamacare is "not unqualified good news," Imara Jones writes in a piece at Colorlines that examines the pros and cons of the linchpin of the Affordable Care Act — millions of uninsured Americans' ability to sign up for plans on their own or through Medicaid — which takes effect on Oct. 1. A vast majority of those "newly eligible for Medicaid under Obamacare — disproportionately people of color and those who work but don't earn enough to live — won't actually be able to join it," Jones writes.

Why the disconnect?

The challenge is that last summer’s 5-4 ruling by the Supreme Court in the healthcare case found that states do not have to expand Medicaid. Though the law’s so-called individual mandate — which requires all uninsured Americans to acquire healthcare or face a tax penalty — grabbed media headlines and absorbed political attention, Medicaid is actually what matters most for historically marginalized communities.

The legal issue is that Medicaid, despite being funded overwhelmingly by the federal government, is technically a state-by-state partnership. Under the Affordable Care Act, 100 percent of the Medicaid expansion would have been paid for by Washington until 2019 and 90 percent thereafter. But as a voluntary collaboration between the states and the federal government, the court held that Medicaid cannot be forced open.

Whatever the legal rationale, the blunt fact is that the court’s opinion and the ensuing political free-for-all leaves the growth of Medicaid in a lurch and places fundamental issues of fairness at the heart of Obamacare's implementation. The program's importance to communities of color is hard to overstate. As the Kaiser Family Foundation points out, "Medicaid enables Blacks and Hispanic Americans to access health care." This statement is not an exaggeration: one out of three African Americans and Latinos receive healthcare through Medicaid.


Read Imara Jones' entire piece at Colorlines.

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