The Affordable Care Act (ACA) coverage expansions provided an opportunity to increase coverage and address longstanding racial and ethnic disparities in health coverage.1 This brief examines changes in health coverage by race and ethnicity between 2013 and 2017, providing insight into how coverage has changed since implementation of the ACA. It is based on Kaiser Family Foundation analysis of the nonelderly population using American Community Survey data. (See methods for more details). It shows: (1) People of color experienced large gains in coverage under the ACA that narrowed longstanding disparities in coverage. Research suggests these gains will likely lead to reductions in disparities in access to and use of health care as well as health outcomes over the long-term. (2) Between 2016 and 2017, coverage gains stalled or began reversing for some groups. The uninsured rate increased for the first time since implementation of the ACA, with small but statistically significant increases in the uninsured rates for Whites and Blacks. (3) Despite the large coverage gains for people of color under the ACA, significant disparities in coverage persist. Recent federal and state policies, including several changes the Trump administration has made to ACA implementation and Medicaid waivers that add eligibility restrictions, may further erode coverage gains and progress reducing disparities. These disparities leave people of color at greater risk of difficulty accessing care and financial instability from health care costs.
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