Fighting Unequal Access

by Marian Jones - Spring 2018

In a 2013 report on healthcare issues among African Americans, radio station WNYC reported on then-52-year-old Mike Jackson, who battled diabetes and hypertension. His prescription drugs cost $500 a month. After he lost his job and healthcare, he cut back on the amount of insulin he took to treat his diabetes. Within eight months he had developed neuropathic damage in his toes and feet and permanent damage in his left eye. His story is not atypical.

A program of universal healthcare such as Medicare for All would have a significant impact on African Americans. Members of our community have higher rates of hypertension, prostate or breast cancer, asthma, and diabetes than non-Hispanic whites. The infant mortality rate among African heritage people is almost two-and-a-half times higher than that of their non-Hispanic white counterparts.

Although there are environmental factors, lack of healthcare coverage is a major cause of these health disparities. African Americans, who have lower incomes than non-Hispanic whites, are more likely to be uninsured. Thus, they put off receiving care, forgo routine doctor visits, and cannot afford the prescription medicine that could help them.

African Americans make up 10% of Medicare beneficiaries and under the current system still have to pay burdensome premiums, copays, and supplemental insurance for services that Medicare does not cover. They have a smaller probability of receiving employer-based coverage or retiree health benefits, as many are employed in low-wage service jobs that do not provide employee benefits. When they reach age 65, they may be receiving decent health care for the first time in their lives, but the cost is high.

Medicaid, a financial-needs-based program that includes the Children’s Health Insurance Program, helps the uninsured who are not eligible for Medicare. Nearly all uninsured African Americans qualify for Medicaid under the Affordable Care Act (ACA, popularly known as Obamacare). However, certain states with Republican-controlled executives declined the expansion in order to undermine the ACA. This exclusion disproportionately harms African Americans, who make up 19% of Medicaid enrollees. As of 2017, only 31 states and the District of Columbia had expanded their Medicaid programs. This has left two-thirds of African Americans and more than half of low-wage workers without adequate care. Most of the non-expansion states are in the South, which is home to 70% of the nation’s poor. If the 19 states that declined the expansion had chosen to comply, an additional 806,000 black people would have become eligible for Medicaid coverage.

The ACA also created a health insurance marketplace that offered tax credits to low-income individuals so that they could purchase insurance under an individual mandate. However, this insurance is inaccessible, as the ACA has not lowered the cost of copayments, deductibles, or premiums. Too many people are paying for insurance that they simply cannot access.

A universal healthcare system that eliminates copays and deductibles, while reining in private insurance avarice, would allow millions of low-income individuals in all ethnic and racial groups to have access to care.

Anti-blackness plays a role in demonizing public programs that should be universal. African Americans are not the only ones to suffer from disparities in health care. Yes, we support Medicare for All in part because of our concern for our community. We also support it because of the impact it would have on all those with whom we stand in solidarity. ϖ