ACA and African Americans

U.S. Department of Health & Human Services

The Affordable Care Act is working in terms of affordability, access, and quality for African American families, seniors, businesses, and taxpayers. This includes African Americans who were previously uninsured and African Americans who had insurance that didn't provide them with adequate coverage and financial security.

African American families have more security, and many of those who already had insurance now have better coverage. Fewer Americans are uninsured. At the same time, as a country, we're spending our health care dollars more wisely and we're starting to receive higher quality care.

Health insurance coverage is now more affordable and accessible for millions of Americans. The Affordable Care Act invests in prevention and wellness, and gives individuals and families more control over their care. In addition, the law addresses disparities in access to quality, affordable health coverage.

Addressing Health Disparities

African Americans suffer from several illnesses at higher rates than non-Hispanic white Americans:

  • They have the highest mortality rate of any racial and ethnic group for cancer generally and for most major cancers individually, including stomach, liver, prostate, and colon cancers.
  • Even though the rate of breast cancer incidence is 10 percent lower among African American women, they are 40 percent more likely to die from the disease. Earlier screening and detection for African American women could help reduce this death rate.
  • Although African American adults are 40 percent more likely to have high blood pressure, they are 18 percent less likely than their non-Hispanic white counterparts to have their blood pressure under control.
  • African American adults are less likely than non-Hispanic white adults to have received the flu vaccine in the past year.
  • African American adults are also twice as likely to be diagnosed with diabetes.
  • The infant mortality rate among African Americans is 2.3 times that of non-Hispanic whites, and African American infants are 4 times more likely than non-Hispanic white infants to die due to complications related to low birthweight.

At the same time, African-Americans are 55 percent more likely to be uninsured than white Americans. In 2013, the proportion of African Americans who were uninsured was 17 percent.

Millions of African Americans across the country are already benefiting from the stronger coverage and consumer protections made possible by the Affordable Care Act:

  • 7.8 million African Americans with private insurance now have access to expanded preventive services with no cost-sharing. This includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.
  • Private plans in the Health Insurance Marketplace are required to cover 10 essential health benefit categories, including maternity and newborn care. Over 390,000 African American women in the individual market alone are projected to gain maternity coverage thanks to the Affordable Care Act.
  • An estimated 5.1 million African American women with private health insurance now have guaranteed access to women’s preventive services without cost-sharing. These services include well-woman visits, HPV testing, breastfeeding support and counseling, mammograms and screenings for cervical cancer, prenatal care, and other services.
  • More than 500,000 African American young adults between ages 19 and 26 who would have been uninsured, including 230,000 African American women, now have coverage under their parents’ employer-sponsored or individually purchased health insurance plan.
  • About 10.4 million African Americans, including 3.9 million adult African American women, no longer have lifetime or annual limits on their health insurance coverage thanks to the Affordable Care Act.
  • Nearly eight million African Americans with a preexisting health condition are no longer at risk of being denied coverage since the ACA prohibits insurers from denying someone coverage or charging them more because of a pre-existing condition.
  • Major federal investments in quality of care are improving management of chronic diseases that are more prevalent among African Americans.
  • The health care workforce is more diverse due to a more than doubling of the National Health Service Corps. African American physicians make up about 18 percent of Corps physicians, a percentage that greatly exceeds their 6 percent share of the national physician workforce.
  • Investments in data collection and research will help us better understand the causes of health care disparities and develop effective programs to address them.
  • The $11 billion in the Affordable Care Act for the nearly 1,300 community health centers has increased the number of patients served by nearly 5 million. Nearly one of every four patients at a health center is African American.

Getting Covered

  • As of June 2014, 1.7 million African Americans (ages 18-64) gained health insurance coverage since the start of the Affordable Care Act initial open enrollment period in October 2013, a 6.8 percentage point drop in the uninsured rate over that period.
  • Consumers have access to health insurance that fits their needs and budget through the Health Insurance Marketplace. All plans in the Marketplace cover essential health benefits, pre-existing conditions, recommended preventive care and more. Open enrollment begins November 15, 2015 and ends on February 15, 2016. Enroll by December 15, 2015 for coverage that starts January 1, 2016.
  • Enrollment in Medicaid and the Children's Health Insurance Program (CHIP) is open year round. And so far, twenty-seven states and Washington, D.C. have expanded Medicaid. If all states took advantage of new opportunities to expand coverage under the Medicaid program, 95 percent of eligible uninsured African Americans might qualify for Medicaid, CHIP, or programs to help lower the cost of their Marketplace coverage.
  • Nearly two thirds (62 percent) of uninsured African Americans have incomes at or below the Medicaid expansion limit of 138 percent of federal poverty level. However, nearly six in ten uninsured African Americans with incomes below the Medicaid expansion limit reside in states that were not planning to expand Medicaid as of late June 2013.

For more information on the Marketplace, Medicaid, and CHIP visit If you have questions or need to find someone who can help you in person, find local help at: Or call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855- 889-4325. The call is free.

1 NCI 2013. Seer Cancer Statistics Review, 1975-2010. Table 1.21.
2 NCI 2013. Seer Cancer Statistics Review, 1975-2010. Table 4.19.
3 CDC 2012. Summary Health Statistics for U.S. Adults: 2011. Table 2.
4 2012 National Healthcare Disparities Report. Table T2_2_1_2-1
5 CDC 2012. Health United States, 2011. Table 88.
6 CDC 2012. Summary Health Statistics for U.S. Adults: 2011. Table 8.
7 CDC 2013. Infant Mortality Statistics from the 2009 Period Linked Birth/Infant Death Data Set. National Vital Statistics Reports. Table A.
8 Kaiser Family Foundation (2013). State Health Facts: Uninsured Rates for the Nonelderly by Race/Ethnicity, Retrieved on 10/23/2014 from
9 Families USA, (2012). Worry No More: Americans with Pre-Existing Conditions Are Protected by the Health Care Law. Washington, DC. accessed October 23, 2014 at
10 Kaiser Family Foundation (2013). Health Coverage for the Black Population Today and Under the Affordable Care Act.
11 Kaiser Family Foundation (2013, June). The Impact of Current State Medicaid Expansion Decisions on Coverage by Race and Ethnicity.

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