Access to the Affordable Care Act

Witshire, Elder, Kiefe, and Allison (2016) established an idea that African Americans are one of the population groups in the country who has medical costs and payments. Multiple of them at once sometimes because of their recurring health issues. This usually is the case for older African Americans for reasons such as the reported poor health or just not understanding how eligibility for Medicaid or other systems works for them. Lack of knowledge is always detrimental to whoever concerning. The expansion of access and coverage along with health insurance also targets the elder.

The financial problems they face can come from not being able to balance the health care services along with other major expenses such as rent or purchasing food. Wiltshire et al (2016) analyzed African American adults and compared their data to White people. A few questions they want to figure the answers to include what the frequent cause of medical debt for this community is and how does White American debt match or correlate to theirs.

By utilizing the Health Tracking Household Survey (JTHS), their curiosities may be answered. The survey tries to eliminate limitations by being nationwide and done through the telephone. Additionally, valuable information such as access and coverage to health care, or the status of health is collected. Although the surveys cover most demographics, Witshire et al. (2016), only used the samples from about 5,500 African American and non-Hispanic White individuals who were over 65 years old. They were able to gather an independent and dependent variable. The independent variable being the race they wanted to gather information from.

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That being African Americans and non-Hispanic White citizens. The dependent variable is in any of the individuals who were in any form of medical debt. All areas surrounding medical debt were being accounted for in their study based on the survey. For instance, those who were classified as being under the federal poverty line (percentage-wise) got a specific label, the type of current health insurance individuals had a label as well. Because of that, all types of circumstances will be present. Which is good for variation because not one individual in the wither racial community has the same exact situation.

They state that by coding for the different types of conditions under the independent variable (race) will ultimately show some inconsistencies between the different residents. Gender, age, and education level were some of the other small groups they also coded for. Seeing that those factors can furthermore contribute to the outcomes of health care. After collecting every piece of their complex data, it was found that the African American sample was majority low income, poor health, and only Medicaid for insurance. Twenty-one percent of them had medical debt, with 7.1% of the non-Hispanic White sample population. It was also found that more education and an older age correspond with a low chance of being in medical debt. Economic factors and racial disparities caused 39% and 35% respectively to cause these sampled African Americans problems in paying for their health services. If medical bills ever became a problem, African Americans would have to usually borrow or loan money in order to pay. While the non-Hispanic Whites have money saved prior to the problem came about. Wiltshire et al. (2016) indicate that African Americans continue to be in debt (though the ACA tries to implement resources) is because of the out of pocket fees or copayments that most insurance companies have. Simply, their funds cannot stretch that far. The expansion of Medicaid did not remove all of the costs for patients, just most of them.

The action of expanding Medicaid ad health insurance could cause for some African Americans to be in medical debt like above. However, the expansion should be more positive than negative. Powell, Frerichs, Townsley, Mayorga, Richmond, Corbie-Smith, Wheeler, and Smith (2020) proposed that the ACA extending access and coverage to health care and insurance may minimize the number of African American males who have colorectal cancer screening problems. They specifically thought to test colorectal cancer (CRC) because it is one of the cancers in the United States that can be prevented, but it is also diagnosed regularly. They credit the Affordable Care Act to being able to get rid of health outcomes due to the patients now able to get the right services done to help recover. CRC for African Americans is deadly compared to White men. Those aged around 60 to 64 should highly benefit from the expansion. For their experimentation, Powell et al. (2020) will look at the state of North Carolina (1 of 13 states who has not expanded their Medicaid policies) in order to observe the possibility of the state’s CRC numbers for screening issues and deaths to decrease. To do so, they used an induvial based model and the Behavioral Risk Factor Surveillance System (BRFSS).

Powell et al. (2020) decided to use the BRFSS so that a precise representation of households and the residents in them were considered. They felt as if that was their best option to gather all of the correct answers they were researching for. Again, African American males were being compared to their counterpart White American males who all live in North Carolina who were getting CRC testing. The ages of the sample population included 50 to 75-year-old men. The type of insurance they had prior to being in the study was recorded. For example, Medicaid, privately insured, or low income uninsured to just name a few. Instead of outright stating what either independent variable or dependent variable they had, they instead listed scenarios that will take the place of a control variable.

The scenario for the ACA implementing the expansion of Medicaid is the major one. In which they will differentiate the CRC screening rates of those patients in states who expanded theirs to the North Carolina patients. For each scenario, they decided collectively to run the simulation many times (5 to be exact) so every sampled person is documented for. Moreover, the results show that generally, the expansion of Medicaid scenario displayed an increasing rate in screenings that were up to date. That scenario also had an impact on decreasing the level of difference between African American males with CRC screenings and White American males. Ultimately, the higher number of United States citizens who have gained coverage for health insurance payments (through the Affordable Care Act expansion) are more likely to witness a drop in colorectal cancer patients. This might be the same for more diseases or illnesses, so more tests and studies need to be organized and occur. There are just way too many African Americans who suffer hardships due to the fact that they cannot finance or fund their own lives truthfully. Hopefully, this is a step in the positive direction, and the 13 other states follow suit

Powell et al. (2020) reveal that states similar to North Carolina who do not have the eligibility for Medicaid for all residents should. With the Affordable Care Act’s help, they were able to see the large impact it had on other states’ deaths from CRC numbers. Like the previous article, the costs of the expansion of health care access and health insurance coverage is still an arising problem. But, for the most part, the ACA has made more Americans survive and bypass the health conditions they were once in. The colorectal cancer mortality standard is low for males in the African American communities because of their ability to now pay for screenings so the tumor could be caught before it spreads far into the body. Powell et al (2020) concluded that the costs should not defer patients to get help for their medical issues. Only because they believe that the amount needed to be paid may eventually go downstream and decline.

All of the answers for trying to improve health care and health insurance systems are not all solved or answered. Sommers, McMurty, Blendon, Benson, and Sayde (2017) state that the Affordable Care Act has made the number of U.S. citizens who are not uninsured to this day is at its all-time low. They claim that there is still a large racial and financial gap between various groups in the country. Minorities (African Americans are involved) are the audience that faces these problems still. Minorities are usually the ones who are considered low income, so there are a substantial number of obstacles in front of them to get the appropriate care health-wise. This is due to a lot of factors including the rebuilding process the entire health care field is undergoing. Because the Affordable Care Act expands the requirement for all United States residents to have health insurance, that leads to lower quality and care to patients who need it. The demand is so high, so it is impossible for every single person to get any type of service pertained to their condition.

Sommers et al. (2017) claim also that about 20 million residents have made that rate so low. Disparities are the main focal point for minorities on account of the surrounding neighborhood or education level. It may be hard for this group of individuals to understand how exactly the mandate of expanding Medicaid relates to them. They also expressed that Massachusetts had a similar act of expanding their health care access and health insurance before the ACA came about. It was a reform created in 2006 that was intended to assist communities such as the elderly, and low to middle-income citizens. That matches up kind of clear to the Affordable Care Act that was established in 2010. That Massachusetts act could be labeled as a model for the ACA. Since some of their policies are similar. They conducted a study that investigated the quality and access of health services post-Affordable Care Act within those affected communities.

Sommers et al. (2017) gathered their date from telephones, and it was randomly selected. Their time frame for this test was over the span of at least 3 months in 2015. Around 8,000 participants all older than the age of 18 were given an over the phone survey. They indicate that Latinos and African Americans who made under $25,000 were the majority of the population who participated. A ton of valuable personal information was asked in the survey. Which is important to have considering that health care involves multiple factors or variables. Some of the personal information comprises household information, past experiences dealing with the health care system, and their point of view of the current status of the health care issues or approach for the state(s) they reside in. As well as that, the usual age, gender, and relationship status were accounted for. Through the multiple questions being asked to the individuals, some had to be answered using a scale that is similar to ranking something from least to greatest. Affordability, quality, access, and more are a few of the points being covered when being asked about your past health care experiences.

By having categories, Sommers et al. (2017) were able to directly dictate and understand the data points that were collected. The subgroups established from the beginning (labeling racial communities, age, financial status, etc.) allowed the findings to be concise and make sense ultimately. They conclude that although disparities are still present in the health care system (post-Affordable Care Act), changes should be evident in the future. They should happen. The ACA appears to make individuals in the expansion states feel more comfortable. At the same time, unfair conditions racial wise still present itself even after the Affordable Care Act tried to add on more Americans into their health insurance coverage and access expansion. The number of disparities is lower than before the ACA, so there is an argument there as well. As the amount of money, you earn for salary decreases and falls under 133% of the federal poverty line, the quality of the services you could get health wise tends to fall as well.

Sommers et al. (2017) reiterate the idea that minorities and low-income individuals are underappreciated in these systems. The mandates aimed to help those types of citizens first but failed by not reaching them all. That may be a hard task to do, but with implementing an act like the ACA means all United States residents should be covered. Leaving it up to the states to plan out their own actions is not good for the groups who really need extra support in funding their health. Their survey has some limitations that can cause one to deflect their findings. However, their general conclusions should be considered. Expanding Medicaid will allow for the statistics to appear to be heading in the right direction. But, the few percentages that are not, weigh heavily on the African American community as they try and save their own lives by attempting to pay for the services themselves. More policies need to be added to support the ones already there. The health care system can help even more than 20 million U.S. citizens.