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    Affordable Care Act-Chance to erase health disparities

    Every year the Agency for Healthcare Research and Quality (AHRQ) publishes its annual National Healthcare Disparities Report, which tracks the inequities in health services in the United States. Since the report was first published in 2003, the findings have consistently shown that while we have made tremendous improvements in quality, we have not been as successful in reducing disparities in health care. 

    When we look at the disparities in health status, access to care, and the provision of health services for vulnerable populations, the numbers are quite alarming! Each year approximately 83,000 racial and ethnic minorities die as a result of health disparities and as a nation we are spending an estimated $300 billion as a result of these racial and ethnic health disparities. Despite the fact that health equity is a key component of the transforming journey of healthcare that we are all embarking on, little has been done to comprehensively address this serious problem at the national level. This brings us to a critical juncture, which presents both a crisis and an opportunity – a crisis in terms of the grave health disparities confronting minorities and an opportunity to address these disparities in a more comprehensive manner moving forward. 

    While the debates continue as to whether or not the Affordable Care Act (ACA) should be implemented, a key component of health reform that is often overlooked includes health equity and the elimination of disparities in health status and healthcare among vulnerable populations. The ACA includes robust health equity-related provisions, which provide a bridge to health equity that affords marginalized groups — particularly racial and ethnic minorities—increased access to culturally appropriate, quality health care, preventative care, and comparative effectiveness research. For racial and ethnic minorities who are the most likely to be uninsured, experience higher unemployment rates, and have a lower income—which makes it harder to obtain employer-sponsored health insurance coverage—Medicaid expansion and the creation of health insurance exchanges would provide these communities access to vital health services. This equates to almost 4 million African Americans gaining coverage by 2016. In addition, the ACA provides a unique opportunity to expand the scope of research related to health disparities, increase diversity in clinical trials, and identify, develop and distribute appropriate interventions and solutions to address these disparities. The law also provides new investments to increase the number of culturally competent primary care physicians and other health professionals.

    For these reasons, the implementation of the ACA is critical to the realization of health equity throughout our country. The recent Supreme Court ruling on the ACA, while essentially weakening a key aspect of the ACA’s efforts to expand health insurance coverage to the working poor—Medicaid Expansion – by making the expansion of this program optional for states, nevertheless upheld the ACA and the provisions aimed at addressing health disparities. This certainly is not the last obstacle confronting the health care law and health equity. 

    Even though there may be upcoming struggles, we are reminded by Dr. Martin Luther King, Jr., “[h]uman progress is neither automatic nor inevitable.... Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.” Health professionals, who are the daily bridge to health care in their community, have the chance to be strong advocates for their patients and the general public. And with the ACA empowering physicians and other health professionals, America will see a time when everyone will be able to have access to life-changing health care, in turn eliminating health disparities in our communities.