Over the last decade, blacks experienced the largest decline in employer-sponsored health insurance coverage. If President Obama's Affordable Care Act (aka Obamacare) is revoked, as the Republican presidential candidates are calling for, blacks and all other groups will find it increasingly difficult to obtain health insurance.
From 2000 to 2010, the employer-sponsored health insurance coverage rate for black workers ages 18 to 64 years old dropped 8.6 percentage points. White and Hispanic workers also experienced health insurance declines, but somewhat smaller ones. Employer-sponsored health insurance coverage declined 6.3 percentage points for white workers and 6.6 percentage points for Hispanics. (Unless otherwise indicated, my employer-sponsored health insurance statistics are taken from my colleague Elise Gould's report, "A Decade of Declines in Employer-Sponsored Health Insurance Coverage.")
Children often receive health insurance coverage through their parents' work. Thus, it is not surprising that black children would see large declines in employer-sponsored health insurance coverage given the trend for their parents.
Like black workers, black children saw the largest decline in employer-sponsored health insurance coverage. Black children experienced a 14.1 percentage-point decline. For white and Latino children, the decline was 9.6 and 8.7 percentage points respectively. Most of these children who lost access to employer-sponsored health insurance were likely able to be covered by public insurance programs for children, but further detailed research on this point would be useful.
Since most workers obtain health insurance via work, the massive job losses of the Great Recession led to steep declines in health insurance coverage. However, it is important to note that the decline in health insurance began even before the Great Recession. As Paul Krugman has observed, even from 2003 to 2007, during the best years of the prior business cycle, health insurance coverage declined for workers. This fact is another indicator that the American economy has not been functioning well for average workers.
One piece of good news is the Affordable Care Act. Although we could have instituted more radical reforms like a Medicare-for-all program, the Act will likely go far in expanding health insurance coverage. The best evidence for this is the tiny uninsured population in Massachusetts. Massachusetts health care reform served as a template for the Affordable Care Act. In 2010, while 15.4 percent of the population nationally was uninsured, only 1.9 percent of Massachusetts residents were uninsured.
The main expansion of health insurance coverage under the Affordable Care Act will begin in 2014, but we have already seen one of its positive effects. In 2010, the Act made it possible for young adults up to 26 years old to be covered by their parents' health insurance policy. From 2009 to 2010, despite large job losses for young adult workers, their rate of health insurance coverage increased. They were the only age group that saw increases in health insurance coverage.
In countries with universal health insurance, jobs losses do not lead to losses of health insurance like they do in the United States. The large job losses that blacks have experienced since the start of the recession has also meant significant losses in health insurance coverage. But it is important to remember that even during the best years of the Bush Administration, blacks and all other workers were losing employer-sponsored health insurance coverage. Without a reform like the Affordable Care Act, the decline in health insurance coverage will continue in good times and bad.