Racial disparities in the US healthcare system are widespread and well documented. Social and economic inequities between racial minorities and their white counterparts have led to lower life expectancy rates, higher infant mortality rates, and overall poorer health for people of color. As the nation's population continues to become more diverse, these disparities are likely to increase if they are not addressed. The Affordable Care Act includes several provisions that specifically aim to reduce inequities for racially and ethnically marginalized groups. These include provisions in the Senate and House bills that aim to expand coverage, enhance awareness and training programs, establish standards for culturally and linguistically appropriate practices, and diversify the health care workforce. The ACA, while not a perfect solution to eliminating health disparities, is an important first step and an unprecedented opportunity to improve health equity in the United States. Provisions to expand Medicaid are central to legislation that seeks to eliminate racial inequities. Minorities make up about a third of the population, but account for more than half of the total 47 million uninsured. This reflects racialized economic structures that leave many minorities unable to afford insurance or access employer-provided coverage. The ACA attempts to reduce the uninsured rate for low-income individuals and families by expanding Medicaid to adults with incomes at or below 138 percent of the federal poverty line. While this provision will help expand coverage to some of the nations poorest people, the Supreme Court's decision to leave the choice to extend it to states has a serious impact on the b...... middle of paper.... …as well as inequalities in education, employment and housing, all contribute to health discrepancies. Health care reform, as envisioned by the ACA, should be viewed as treating the symptoms of an unequal system, not as treating the cause. To speak metaphorically, America has a pre-existing condition of institutional racism. The capitalist structure, climate and political discourse, as well as notions of imperialism, deny treatment. The Affordable Care Act addresses this condition as a localized, rather than systemic, disease, the cause of which is rooted in the hegemonic reproduction of ideological superstructures. Only when health care is treated as a fundamental right, rather than an economic good, and health disparities are recognized in a broader political context, can health reform offer the opportunity to overcome racial disparities and achieve health equity..
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