Affordable Care Act anniversary marks gains for insured Black Americans

During a White House ceremony commemorating the anniversary, President Joe Biden called the signing of ACA an “extraordinary achievement” of former President Barack Obama's. 

Thirteen years ago this week, President Barack Obama signed into law the Affordable Care Act, opening up new pathways to quality and affordable health care for millions of Americans.

During a White House ceremony commemorating the anniversary on Thursday, President Joe Biden called the signing of ACA an “extraordinary achievement” of Obama’s. 

“While the Affordable Care Act has been called a lot of things, Obamacare is the most fitting description,” said Biden. 

President Joe Biden speaks during a ceremony marking the 13th anniversary of the Affordable Care Act on March 23, 2023 in the East Room of the White House in Washington, D.C. (Photo by SAUL LOEB/AFP via Getty Images)

When the law was signed in 2010, then-Vice President Biden infamously said to Obama on a hot mic that it was a “big f—ing deal.” Referencing the viral moment, the president added, “I stand by the fact that it was a big deal.”

The landmark legislation has steadily reduced the number of uninsured Black Americans over the years. The Department of Health and Human Services said in a report last year that the uninsured rate among Black Americans has decreased 40% since the ACA was implemented.

Chiquita Brooks-LaSure, the administrator of the Centers for Medicaid and Medicare Services in the Biden administration, told theGrio that the number of Black Americans enrolled in the ACA this year is about the same as last year, which experienced a record increase of 35%.

“The Biden-Harris administration has made such a priority to make sure we have outreach across the country and are really working with trusted partners and that’s why we’ve seen a real increase in people of color, communities of color enrolling,” said Brooks-LaSure.

Brian Smedley, a senior fellow and equity scholar at the Urban Institute, pointed out that the Affordable Care Act also includes civil rights provisions for patients of color who historically experienced inequitable care in America’s health care system. 

President Barack Obama signs the Affordable Health Care for America Act during a ceremony with fellow Democrats on March 23, 2010 in the East Room of the White House in Washington, D.C. (Photo by Win McNamee/Getty Images)

He told theGrio, “There were provisions related to health care quality, trying to advance equity and then, importantly, expanding civil rights protections so that patients can have legal protections against unlawful treatment.”

Despite the gains in creating equal access to quality and affordable health care in America, racial disparities remain, such as disparities in health outcomes and a racial gap between the number of uninsured Black Americans and their white counterparts.

According to the Kaiser Family Foundation, the uninsured rate for Black people was 10.9% as of 2021 compared with 7.2% for white people. Though there is still a gap, it has decreased significantly since 2010. The Kaiser report shows that in 2010 — perhaps shortly before or after Obamacare became the law of the land  —  the percentage of Black Americans who were uninsured was 20% compared with 13% for their white counterparts.The uninsured rate for both groups has dropped dramatically during the Obamacare era.

Though millions of Black Americans remain uninsured, Smedley said they are predominantly found in southern states that have refused to expand Medicaid. A 2012 Supreme Court ruling allowed expansion to be optional for states. Since then, many Republican-controlled states have opted out. To date, 10 states have not expanded Medicaid services.

On Thursday, North Carolina, which has a Democratic governor, became the 40th state to expand Medicaid. During a White House press call, HHS Secretary Xavier Becerra called it a “proud moment.”

Smedley of the Urban Institute said for the remaining 10 states that have not expanded Medicaid, there is lower access to health care on average. They are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.

He continued, “many of these states are losing hospitals, for example, because they refuse to accept the Medicaid expansion. These are all issues that have a disproportionate impact on people of color and Black Americans in particular.”

Smedley said the gap in health insurance coverage is also rooted in structural racism. “White Americans have much better access to high-quality education, better access to professional jobs that provide employer-sponsored insurance,” he said. “So we got to first and foremost consider the systemic racism that leads to socio-economic inequities that Black Americans face in the first place.”

The Department of Health and Human Services noted in a 2022 report that the uninsured rate for Black Americans has decreased by 40% since the Affordable Care Act was implemented.(Photo: Getty Images)

Millions of Americans benefited from increased funding for Medicaid programs because of the American Rescue Plan, which was intended to offset the economic impacts of the COVID-19 pandemic. However, that increased funding is set to phase out starting at the end of this month.

CMS Administrator Brooks-LaSure told theGrio, “We are laser-focused on trying to make sure that people either stay in Medicaid if they’re still eligible or transition to the marketplace or employer-sponsored insurance coverage.”

She added, “We are working with the states. We are working with health plans, advocacy organizations to make sure that people know that they need to fill out their paperwork and may need to transition to new coverage.”

During a White House press briefing on Wednesday, press secretary Karine Jean-Pierre praised the Affordable Care Act for its progress in “lowering health care prices, increasing the number of Americans with insurance, and capping out-of-pocket drug costs for seniors on Medicare.”

The Biden spokesperson touted the administration’s economic policy, which is meant to build on the momentum of the ACA, including the passage of the Inflation Reduction Act. The IRA, in particular, capped the cost of insulin for seniors.

“We understand that there are still millions of people that need a lot more,” she told theGrio. “But because of the president’s economic policy, because of his understanding of what health care means to people, his personal understanding of that, he has done the work to make sure that people who are normally forgotten are not.”

Gerren Keith Gaynor

Gerren Keith Gaynor is the Managing Editor of Politics and White House Correspondent at theGrio. He is based in Washington, D.C.

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