In February, I wrote that the thread that seems to connect nearly all of the policy ideas coming from the Trump administration and Congress seems to be an attack on communities of color. Since then, it’s only gotten worse.
No proposal better exemplifies the war on Americans of color than the attempt to repeal and replace the Affordable Care Act, aka “Obamacare.” And that won’t change whether or not the current “Trumpcare” replacement proposal passes the House of Representatives later today.
Multiple surveys have documented the huge drop in Americans without health insurance since the ACA took effect, with most estimates putting the number who have gained insurance at about 20 million. A number that massive cuts across all races and ethnicities, but when you dig into the numbers, the story gets really interesting.
The uninsured rate peaked in the fourth quarter of 2013, just as the ACA was starting to kick in. At that time, according to Gallup, 11.9 percent of white Americans lacked health coverage. For African Americans the uninsured rate was nearly double that at 20.9 percent. And a staggering 38.7 percent of Latinos had no health insurance, more than triple the uninsured rate for non-Hispanic whites.
Gallup did not report health insurance figures for Asian Americans, but other data show an average uninsured rate for Asian Americans of 15 percent, with huge variations between nationalities, and native Hawaiians and Pacific Islanders at about 18 percent uninsured.
This huge racial health insurance gap stems from a number of causes. In many cases, people of color are less likely to work for employers or in occupations that include employer-paid coverage. When it comes to paying for insurance yourself, America’s yawning racial wealth gap rears its ugly head. According to the last figures reported by the U.S. Census, for every dollar of wealth a white family has, the median Asian American family has 81 cents, the median Latino family has about seven cents, and the median African American family has less than six cents. For too many families, the money just isn’t there.
The ACA did a lot to close the gap in health insurance rates. For whites, the percentage lacking health coverage dropped by five percentage points, according to Gallup. For African Americans the uninsured rate dropped by 8.4 points, and for Latinos the drop was a staggering 11.3 points.
And while we don’t have Gallup figures for Asian and Pacific Islander Americans, we know they tended to be early adopters of Obamacare at higher rates than the U.S. average, and their uninsured rate dropped by more than half after the law went into effect.
We have every reason to expect these gains to vanish if the ACA is repealed and replaced with anything like the current proposal, which has been almost universally denounced by major medical and health organizations because it would take coverage away from so many.
Make no mistake: While Trumpcare would be bad for all Americans, it targets Americans of color for the most severe damage. And the struggle the president and the House GOP have faced trying to scrounge up enough votes to pass their plan doesn’t change that picture. After all, the reason Speaker Paul Ryan had to postpone Thursday’s scheduled vote was because the far-right “House Freedom Caucus” insisted on making the bill even crueler and meaner than it already was. While some Republican moderates have seemed genuinely alarmed at how many people would lose coverage, a larger faction seems intent on making sure that what insurance Americans could still get would be so riddled with loopholes as to be nearly useless when people actually get sick.
Even if the current version of Trumpcare goes down to the defeat it deserves, the attempt to kill the Affordable Care Act will continue (remember, the administration has already begun to sabotage the law administratively, regardless of legislation). And it’s just one part of an ongoing, multipronged attack on Americans of color.