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. 2022 Aug 30;22(1):1638.
doi: 10.1186/s12889-022-14033-8.

Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review

Lonnie R Snowden  1 , Genevieve Graaf  2 , Latocia Keyes  3 , Katherine Kitchens  4 , Amanda Ryan  4 , Neal Wallace  5
Affiliations

Did Medicaid expansion close African American-white health care disparities nationwide? A scoping review

Lonnie R Snowden et al. BMC Public Health. .

Abstract

Objectives: To investigate the impact of the Affordable Care Act's (ACA) Medicaid expansion on African American-white disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes.

Design: A search of research reports, following the PRISMA-ScR guidelines, identified twenty-six national studies investigating changes in health care disparities between African American and white non-disabled, non-elderly adults before and after ACA Medicaid expansion, comparing states that did and did not expand Medicaid. Analysis examined research design and findings.

Results: Whether Medicaid eligibility expansion reduced African American-white health coverage disparities remains an open question: Absolute disparities in coverage appear to have declined in expansion states, although exceptions have been reported. African American disparities in health access, treatment, or health outcomes showed little evidence of change for the general population.

Conclusions: Future research addressing key weaknesses in existing research may help to uncover sources of continuing disparities and clarify the impact of future Medicaid expansion on African American health care disparities.

Keywords: Affordable care act; Health disparities; Health policy; Medicaid expansion; Racial disparities.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA-ScR 2020 flow diagram. Adapted from: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71. For more information, visit: http://www.prisma-statement.org/
See this image and copyright information in PMC

References

    1. Hill L, Artiga S, Haldar S. Key Facts on Health and Health Care by Race and Ethnicity. Kaiser Family Foundation; 2022 [cited 2022 Jul 25]. Available from: https://www.kff.org/racial-equity-and-health-policy/report/key-facts-on-...
    1. National Center for Health Statistics. Health, United States, 2017: With Special Feature on Mortality. Hyattsville (MD): National Center for Health Statistics (US); 2018 [cited 2020 May 20]. (Health, United States). Available from: http://www.ncbi.nlm.nih.gov/books/NBK532685/ - PubMed
    1. Suthers K. Evaluating the Economic Causes and Consequences of Racial and Ethnic Health Disparities. Issue Brief: American Public Health Association; 2008.
    1. Bound J, Waidmann T, Schoenbaum M, Bingenheimer JB. The Labor Market Consequences of Race Differences in Health. Milbank Q. 2003;81(3):441–473. doi: 10.1111/1468-0009.t01-1-00063. - DOI - PMC - PubMed
    1. Michener J. Race, Politics, and the Affordable Care Act. J Health Polit Policy Law. 2020;45(4):547–566. doi: 10.1215/03616878-8255481. - DOI - PubMed

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