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Blacks Gain Most from Obamacare When Medicaid Expanded

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FILE - This Nov. 29, 2013, file photo shows a part of the HealthCare.gov website, photographed in Washington. If you have health insurance on your job, you probably don't give much thought to each year's renewal. But make the same assumption in one of the new health law plans, and it could lead to costly surprises. Insurance exchange customers who opt for convenience by automatically renewing their coverage for 2015 are likely to receive dated and inaccurate financial aid amounts from the government, say industry officials, advocates and other experts.  (AP Photo/Jon Elswick, File)

This Nov. 29, 2013, file photo shows a part of the HealthCare.gov website, photographed in Washington. (AP Photo/Jon Elswick, File)

By Freddie Allen
NNPA Senior Washington Correspondent

WASHINGTON (NNPA) – As families prepare to choose health insurance coverage during the open enrollment period, a recent report by the Urban Institute shows that Blacks have the most to gain from the Patient Protection and Affordable Care Act (ACA) if the states they live in expand Medicaid under the law.

The Urban Institute, a nonprofit research group focused on social and economic policy, estimated that Blacks will experience, “the largest decreases in uninsurance rates under full Medicaid expansion: a drop from 11.3 percent (projected with current expansion decisions) to 7.2 percent” and the uninsurance rate gap between Blacks and Whites will fall from 6.5 percent under current Medicaid expansion to 2.6 percent with full expansion.

However, the gap between Black and White uninsurance rates will remain closer to 7 percent, at least for the near future, because most Blacks live in states that have refused to expand Medicaid under the ACA.

The original law, passed in 2010, mandated Medicaid expansion nationwide, but the United States Supreme Court 2012 decision in the National Federation of Independent Business v. Sebelius case reversed that provision, leaving it to the states to decide whether they want to take additional Medicaid funding under the ACA.

According to the Urban Institute, “As of December 2014, 27 states and the District of Columbia had expanded Medicaid or planned to expand by January 2015.”

The Urban Institute projected that Blacks would comprise 12.8 percent of all coverage gains under current Medicaid expansion policies and 2.9 million Blacks would get health insurance. The uninsurance rate for Blacks would fall from 19.6 percent to 11.3 percent.

More than half of all Blacks live in states, primarily in the South and led by Republican governors, that didn’t expand Medicaid after the ACA was passed in 2010.

When states refused to expand Medicaid, the move trapped Blacks in a “coverage gap,” because many of them don’t meet the income-based requirements to qualify for Medicaid under their own state rules or to receive subsidies through the ACA marketplace.

About 1.4 million Blacks fall into this category, accounting for more than 23 percent of the uninsured non-elderly adult Blacks. For example, in Florida, Georgia, Texas and North Carolina, the uninsured rates for Blacks would plummet roughly 30 percent compared to current rates, if those states expanded Medicaid coverage under the ACA.

“For blacks, however, the difference between their uninsurance rates and whites’ rates is projected to narrow under the ACA with current Medicaid expansion decisions only in Medicaid expansion states,” the report said. “Across all states, the difference in uninsurance rates between blacks and whites is projected to stay approximately the same both under the ACA with current Medicaid expansion decisions and without the ACA.”

In August 2014, researchers with the Urban Institute said that 6.7 million residents would still remain uninsured in 2016 in the states that continued to block Medicaid expansion through the ACA.

“These states are foregoing $423.6 billion in federal Medicaid funds from 2013 to 2022, which will lessen economic activity and job growth,” the August 2014 report said. “Hospitals in these 24 states are also slated to lose a $167.8 billion (31 percent) boost in Medicaid funding that was originally intended to offset major cuts to their Medicare and Medicaid reimbursement.”

The report continued: “For every $1 a state invests in Medicaid expansion, $13.41 in federal funds will flow into the state.”

The Council of Economic Advisers (CEA), a small group that offers the president domestic and foreign economic advice, predicted that, Medicaid expansion would have added, in nonexpanding states, nearly 79,000 jobs in 2014, “172,400 jobs in 2015, and 98,200 jobs in 2016.”

The August 2014 report also noted that that the rate of uninsured in the states that expanded Medicaid fell by nearly 40 percent, since September 2013, the number of uninsured in the non-expansion states fell by less than 10 percent.

The technical difficulties that plagued the rollout of HealthCare.gov last year have faded from headlines, and the benefits of Medicaid expansion under the Affordable Care Act become harder for governors and state legislators to dismiss.

In December, Republican Tennessee Gov. Bill Haslam moved to expand Medicaid under the ACA, leaving less than two dozen states to weigh providing health care for their poorest residents against future costs associated with Medicaid.

The Urban Institute report on uninsurance rates under the ACA said that improving health literacy, translation services, outreach through ethnic media and working with trusted members of the community can also aid in driving down the levels of uninsured.

According to a recent report by the Department of Health and Human Services (HHS), 87 percent of the people who selected health insurance plans through HealthCare.gov were eligible for financial assistance, a 7 percent increase over last year’s numbers.

“That includes more than 3.4 million people who selected a plan in the 37 states that are using the HealthCare.gov platform for 2015, and more than 600,000 consumers who selected plans in the 14 states that are operating their own Marketplace platform for 2015,” stated a press release on the report.

A more detailed view of enrollment data collected from November 15 to December 26 showed that roughly 6.5 million people either selected plans or were automatically reenrolled.

HHS Secretary Sylvia Burwell said that the vast majority of people who signed up for health insurance coverage through HealthCare.gov were able to lower their costs using tax credits.

“Interest in the Marketplace has been strong during the first month of open enrollment,” Burwell said in a recent press release about the enrollment report. “We still have a ways to go and a lot of work to do before February 15, but this is an encouraging start.”

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Doctors Seeing More Cases of Preventable Childhood Illnesses

OAKLAND POST — Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

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By Stacy M. Brown

Doctors across the United States say they are treating children for illnesses that routine vaccinations once made increasingly uncommon, raising concerns that years of declining immunization rates are beginning to reverse decades of public health progress.

Pediatricians have described seeing more cases of whooping cough, rotavirus infections, bacterial pneumonia and other potentially life-threatening illnesses that vaccines have long helped suppress. Some physicians reported treating conditions they had rarely encountered during their careers, while others said that growing vaccine hesitancy is changing how emergency rooms and hospitals care for children.

The reports come as measles outbreaks continue to spread across multiple states and vaccination coverage remains below federal public health targets.

Johns Hopkins University’s International Vaccine Access Center reported 2,077 confirmed measles cases nationwide as of May 29. Researchers warned that outbreaks reported across the country have raised concerns about continued transmission, additional hospitalizations and deaths, and the possible loss of the nation’s measles elimination status.

Public health experts have long viewed measles as a warning sign because of its ability to spread rapidly through communities with lower vaccination coverage. The New York Times reported that physicians increasingly fear the resurgence of measles may be followed by the return of other vaccine-preventable diseases.

Doctors say that is already happening.

Dr. Meghan Hofto, a pediatric hospitalist at the University of Alabama at Birmingham, said she has already treated roughly as many children with rotavirus this year as she saw during the previous decade. Rotavirus once caused tens of thousands of hospitalizations annually before vaccines sharply reduced its spread. None of the children she treated this year had been vaccinated.

Hofto also described caring for infants with pertussis, commonly known as whooping cough.

“It’s hard to know when they’re safe to go home,” Hofto told The Times.

The rise in whooping cough cases has been particularly striking. More than 28,000 cases were reported nationwide last year, compared with approximately 7,000 in 2023, according to figures cited by The Times. Many of the affected infants were too young to receive vaccinations themselves and relied on broader community protection to reduce their exposure.

Other doctors described similarly troubling cases.

Dr. Jessica Kirk, a pediatric hospitalist in Alabama, recently treated an unvaccinated toddler hospitalized with pneumonia caused by simultaneous infections of Haemophilus influenzae and Streptococcus pneumoniae. Vaccines exist to protect against both illnesses. The child required oxygen and antibiotics to recover.

Researchers at Johns Hopkins have been tracking vaccination trends nationwide and found continuing signs of vulnerability.

At the same time, vaccine policy has become increasingly contentious in state legislatures.

Johns Hopkins researchers reported that lawmakers across the country continue to introduce bills affecting childhood vaccination requirements, vaccine access and non-medical exemptions. Researchers also noted that state policies governing exemptions remain a significant factor in vaccination coverage and disease transmission risks.

Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

For doctors confronting the return of illnesses that vaccines once pushed to the margins of American medicine, the challenge is becoming increasingly personal.

“It just feels like you’re a tiny little boat with a giant tidal wave coming at you,” Dr. Erin Charles, a regional pediatric hospitalist at Seattle Children’s Hospital, told reporters. “And you might convince one family here and there.”

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Community

Asm. Isaac Bryan’s Environmental Reparations Bill Passes on Assembly Floor

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

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Asm. Isaac Bryan (D-Ladera Heights). File photo.

By Bo Tefu, California Black Media

On May 26, the California State Assembly passed legislation to provide direct financial assistance to families harmed by pollution from a major urban oil field in South Los Angeles.

Assembly Bill (AB) 1661, introduced by Assemblymember Isaac Bryan (D-Ladera Heights), cleared the Assembly floor with a 44-10 vote after lawmakers concluded debate on the measure.

The bill would direct money from a community repair fund toward families who suffered negative health effects from living near what Bryan described as the state’s largest toxic urban oil field. The repair fund was created under legislation approved two years ago that shut down the oil field and required polluters to contribute financially to community recovery efforts.

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

Bryan called the proposal “the largest environmental reparations opportunity for South LA” and told lawmakers the bill had not received opposition during the legislative process.

The legislation is part of California’s broader push to address environmental justice concerns in communities historically exposed to industrial pollution. South Los Angeles residents and environmental advocates have long raised concerns about health risks associated with oil drilling operations near homes, schools and parks.

Supporters say the measure represents a new approach to environmental accountability by ensuring that communities affected by pollution directly benefit from funds collected from responsible companies.

After debate concluded, Assembly leadership opened the roll call vote, and the measure passed with majority support from lawmakers.

AB 1661 now moves to the Senate for further review.

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Activism

Rep. Kamlager-Dove Introduces Bill to Protect Women in Custody After Reports Detailing Miscarriages and Neglect

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

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By Bo Tefu, California Black Media

Congresswoman Sydney Kamlager-Dove (D-CA-37) on May 7, reintroduced updated legislation aimed at strengthening protections and healthcare standards for pregnant and postpartum women held in federal custody, including in immigration detention facilities.

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

The legislation builds on a bipartisan version previously passed by the House during the 117th Congress. The updated bill includes new standards for healthcare access, mental health and substance use treatment, high-risk pregnancy care, family unity protections and increased federal oversight.

“Proper pregnancy care is a human right, regardless of your immigration or incarceration status,” Kamlager-Dove said in a statement. “It’s unacceptable that there are virtually no legal safeguards for pregnant women in federal custody.”

The bill would also limit the use of restraints and restrictive housing for pregnant women, improve data collection on maternal health in custody and require additional staff training and enforcement measures.

Supporters of the measure said the legislation is intended to address long-standing concerns about maternal healthcare and safety in detention settings, particularly for Black women and low-income women who are disproportionately impacted by incarceration and health disparities.

“Pregnant women in custody should never be subjected to dangerous and inhumane treatment that threatens their health, dignity, or the well-being of their babies,” said Patrice Willoughby, chief of policy and legislative affairs for the NAACP and a longtime public policy and government affairs strategist, in a statement.

A 2021 report estimated there are about 58,000 admissions of pregnant women into U.S. jails and prisons each year. Kamlager’s statement also cited a recent investigation by NBC News and Bloomberg Law that identified allegations of severe mistreatment or medical neglect involving at least 54 pregnant women or families in county jails between 2017 and 2024.

Federal policy under the Department of Homeland Security restricts the detention of pregnant, postpartum and nursing immigrants except in extreme cases. However, the agency reported that ICE deported 363 pregnant, postpartum or nursing women between January 2025 and February 2026, including 16 recorded miscarriages during that period.

The bill is cosponsored by several House Democrats and backed by organizations including the NAACP and the Vera Institute of Justice.

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