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Black, Hispanic populations may be underserved due to ACA provisions

Many young black and Hispanic adults are not getting the trauma care they need due to racial disparities from the dependent care provision of the ACA, according to a recently published study.

“Our findings show that the [dependent care provision] led to a substantial decrease in uninsured rates for young adult trauma patients of all races; however, benefits of the [dependent care provision] were concentrated among white patients,” John W. Scott, MD, MPH, of the Center for Surgery and Public Health, Brigham & Women’s Hospital, Boston, and colleagues wrote.

Scott and colleagues evaluated data from the 2007-2012 National Trauma Databank to compare coverage changes among those who fell under the dependent care provision (DCP), aged 19-25 years (n = 529,844), and those who did not, aged 27-34 years (n = 484,974).

Prior to the implementation of the DCP, uninsured rates were highest among blacks (48.1%) and Hispanics (44.3%), with only 28.9% of non-Hispanic whites being uninsured.

After the DCP, a 17% reduction was seen in uninsured young white adults, compared with a 6.1% reduction for young black adults and only a 3.7% reduction for Hispanics. A significant reduction in the uninsured rate occurred among non-Hispanic whites (– 4.9 percentage points) compared with blacks (– 2.9, P = .01) and Hispanics (– 1.7 P < .001), following the DCP.

Geographically, the South and West had the largest racial disparities in regard to uninsured young adults (P < .01).

“The dependent coverage provision is a good first step in expanding access to care, however, additional, complementary provisions — like the Medicaid expansion — could help to fill in these gaps we’ve identified. If access does not continue to improve, those left behind by the dependent care provision will have an even harder time catching up,” Scott said in a press release. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.