Health

Blacks Gain Most from Obamacare When Medicaid Expanded

Published

12 years ago

January 6, 2015

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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Doulas Are Helping Black California Moms Navigate Pregnancy–Even as High Mortality Rates Persist

In California, Black women experience the highest pregnancy-related mortality rate — about four times greater than other women, according to statistics. From 2021 to 2023, the leading causes of pregnancy-related deaths included cardiovascular disease, COVID-19, hemorrhage, sepsis, amniotic fluid embolism, and pulmonary embolism.

Published

6 days ago

September 24, 2026

Post News Group

Long Beach resident Cassandra Carter approached the birth of her daughter, Nyomi (pictured), last November with anxiety after losing twins. She is pictured here with her husband.

By McKenzie Jackson, California Black Media

After losing twins, Long Beach resident Cassandra Carter approached the birth of her daughter, Nyomi, last November with anxiety. She wanted support for herself and her husband, Adewole, that extended beyond routine medical care.

“Getting pregnant as a Black woman, I wanted a team around me that made me feel safe,” she said. “I know all about the mishaps that Black women experience.”

Carter, a therapist and self-described hippie, hired Yvette Perry, a doula and co-founder of Divine Birthing Services LLC in Lancaster. Perry helped Cassandra craft a detailed birth plan.

“I was worried about postpartum depression. Mrs. Yvette knows a lot about how postpartum affects men as well,” Carter explained.

Perry was present the day Nyomi was born. She held the baby when Carter or her husband needed a moment and even set up candles in the birthing suite.

“Whatever I needed for my comfort, she was there,” Carter said of Perry. “She was there as an advocate and voice. I had a really serene birthing experience because I had someone extra who wasn’t tied to me as my family.”

Perry, a doula for nearly six years, said preexisting conditions, poor communication and dismissive hospital care heighten health risks for Black mothers.

“Sometimes, Black mommies are not being heard. They don’t know they have rights. They don’t know they can say, ‘no,’” Perry explained. “Doulas empower them. We are there to educate them.”

Perry’s concerns reflect a broader public health crisis. According to the Centers for Disease Control and Prevention’s 2024 maternal mortality report, non-Hispanic Black women in the U.S. died from pregnancy-related causes at a rate of 44.8 deaths per 100,000 live births.

The Centering Black Mothers in California report found that structural racism — including barriers to high-quality health care, and chronic stress— disproportionately harms Black women.

In a statement to California Black Media (CBM), the California Department of Public Health (CDPH) said maternal mortality disparities stem from multiple factors. The department said addressing structural racism, listening to Black women’s experiences and reducing provider bias are key to closing the gap.

California began covering doula care as a Medi-Cal benefit in 2023, providing eligible patients with support during pregnancy, childbirth and the postpartum period, according to CDPH.

Whitney Dotson of Inglewood wanted an expert on pregnancy, labor, and delivery to guide her and her husband, Anthony, through the birth of their son, Anthony III. So, she hired Perry for doula support.

“It’s always more comfortable when you can have a second opinion,” she said. “Knowing she was better versed in what the options were, made me more comfortable.”

Dotson, 39, had a healthy pregnancy but faced recommendations common for expectant mothers over 35. Her doctor advised inducing labor at 39 weeks, but she hoped to carry to full term.

“I wasn’t comfortable with that,” she admitted.

Perry provided Dotson with information about induction guidelines and alternatives, helping her understand her options and communicate her preferences.

Then, Dotson returned to her doctor.

“I said, ‘I don’t want to — and this is why,’” she recalled. “He agreed and pushed the induction date back a week.”

Perry also advised Anthony on how he could support his wife during and after the pregnancy and during Anthony III’s birth. She also reminded Dotson to change birthing positions — from her back to her hands and knees.

Before Saveneh Martinez became a doula with Fierce Advocates in Contra Costa County, she was a new mom, uneducated on aspects of birth, which led to her first child, Colton, being placed in a Neonatal Intensive Care Unit.

“I didn’t know my choices,” she said.

Martinez called it “lifesaving” for expecting moms to have a doula.

“It should be a medical right,” she said.

California Perinatal Quality Care Collaborative (CPQCC) Senior Associate Medical Director Kimberly D. Gregory said research suggests that doulas decrease the pre-term birth rate and the likelihood of a C-section.

“Having a doula is a proactive thing to do,” she said.

Efforts are being made across the state to reduce maternal deaths.

CDPH’s Title V Action Plan aims to reduce pregnancy-related deaths among Black birthing mothers from 49.7 to 42.3 per 100,000 live births by 2030 through improvements in patient-centered care, expanding community-based perinatal teams, and addressing the social factors that contribute to poor maternal health outcomes.

CDPH’s Black Infant Health (BIH) Program and Perinatal Equity Initiative (PEI) have already begun to make headway.

“BIH’s prenatal group model improves key intermediate outcomes for participants, including increased social support and empowerment, better stress management, reduced depressive symptoms and gains in health knowledge and behaviors such as safe sleep practices and reduced smoking,” the CDPH told CBM.

“PEI’s early implementation results show progress across several participant-reported areas, such as improved birth experiences, breastfeeding initiation, and coparenting skills among fathers and partners,” the CDPH statement continued.

Gregory said the California Pregnancy Associated Review Committee examines maternal deaths and develops guidelines to help hospitals improve care. One of its main recommendations focuses on how hospitals respond to hemorrhaging, a leading cause of pregnancy-related deaths.

Gregory said CMQCC also created standard clinic care practices for cardiovascular disease and sepsis, two more drivers of maternal mortality, but widespread implementation across the state is pending.

She noted that although there are 800 maternal deaths a year in the U.S., there are also 3.6 million births.

“Most people will do well,” she said. “But you should know about complications like preterm birth. You should know about complications like diabetes, preeclampsia and postpartum depression.”

Martinez said doulas help to make birthing the transformative experience that it is, instead of a routine clinical transaction.

“Being able to feel heard, seen, safe, respected, and just being able to create spaces for them to be held as well,” she said.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

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On Your November Ballot: Prop 38 Would Allocate $8.4 Billion to Immunology and Immunotherapy Funding

“Yes on 38”, with the tagline “Californians for Life-Saving Immunology Research and Cures,” is leading the campaign for the support side of the proposition.

Published

1 week ago

September 22, 2026

Post News Group

By Austin Gage, California Black Media

California voters will decide in November whether Proposition (Prop) 38 should authorize substantial state funding for immunology and immunotherapy research.

The initiative would fund immunology and immunotherapy research aimed at harnessing the body’s immune system to develop new treatments, medical procedures and potential cures for diseases such as cancer, Alzheimer’s disease and heart disease.

More specifically, Prop 38, titled the Immunology and Immunotherapy Research Funding Initiative, is split into three main components that would go into effect if passed.

First, the initiative would authorize the state to issue $8.4 billion in general obligation bonds to support immunology and immunotherapy research. At least half of the bond proceeds, or $4.2 billion, would be dedicated exclusively to research.

Additionally, Prop 38 would make it mandatory for the state to enter into an agreement with a qualified nonprofit institute focused and dedicated to researching immunology and immunotherapy within 90 days of the initiative’s effective date. The research institute must be affiliated with the University of California.

The third component mandates that the remaining bond revenue must be directed to California-based public and nonprofit medical institutions through a peer-reviewed grant process.

“Yes on 38”, with the tagline “Californians for Life-Saving Immunology Research and Cures,” is leading the campaign for the support side of the proposition.

Along with the campaign, organizations that have publicly supported the ballot initiative include the California Democratic Party, The ALS Association, Alzheimer’s treatment and advocacy organizations, California Black Health Network, Parkinson Association of Northern California and Reform California among others.

“California has an opportunity to accelerate lifesaving medical breakthroughs. Immunotherapies work differently than traditional treatments. Instead of attacking cells directly, they empower the body’s own immune system to recognize and stop disease. Today, these therapies are already treating certain cancers and chronic conditions — and researchers continue to expand what’s possible. This initiative invests in proven science so cures can move from the lab to patients faster,” said the campaign.

No on Proposition 38 is leading the campaign against the measure, with support from the League of Women Voters of California. Opponents argue that California cannot afford to assume $8.4 billion in debt for medical research that may not produce definitive results. They also object to directing more than half of the bond proceeds — $4.2 billion — to a single qualifying nonprofit research institute, arguing that funding decisions of this magnitude should be made through the state’s regular budget process.

“Medical research can save lives, but Prop 38 is the wrong way to fund it. It would authorize $8.4 billion in borrowing for immunology and immunotherapy research and require the state to make $500 million to $600 million in annual debt payments for about 20 years. Those payments would come from the General Fund, which also pays for schools, health care, and other public services,” the League of Women Voters of California said.

A “yes” vote would authorize $8.4 billion in state bonds to fund immunology and immunotherapy medical research.

A “no” vote would reject the proposed bond funding.

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Community

Two Looming Threats Every Alameda County Elder Should Know About

Federal changes enacted under H.R. 1 are bringing new eligibility, reporting, and coverage rules beginning in 2027. Although Californians age 65 and older and people with disabilities are exempt from the new 80-hour-per-month work requirement and will continue with annual rather than six-month renewals, that does not mean elders can ignore the coming changes.

Published

1 week ago

September 22, 2026

Post News Group

By Tanya Dennis

Alameda County elders are urged to attend the Elder Justice Symposium at Oakland City Hall on Sept. 25, from 9 a.m. to 5 p.m., for information that could profoundly affect both their health care and the legacy they hope to leave their families.

For many older adults, a lifetime of hard work has produced two things they understandably want to protect: access to health care while they are living and the home, savings, and other assets they hope to pass to loved ones when they die.

Changes already underway in California make understanding how to protect both increasingly urgent.

The first threat involves Medi-Cal.

California has already reinstated an asset test for certain Medi-Cal recipients age 65 and older, people with disabilities and those needing long-term care. Assets must be reported when applying or renewing coverage.

And another significant change is coming.

Beginning July 1, 2027, California says the Medi-Cal asset limit for affected beneficiaries will fall from $130,000 for one person to just $21,000, and to $31,000 for two people, with certain assets excluded and special rules applying in some circumstances.

There is more. Beginning Jan. 1, 2027, Medi-Cal’s retroactive coverage period will also shrink. For most beneficiaries outside the ACA expansion adult group, coverage of qualifying medical expenses incurred before application will be reduced from three months to two.

For an elder facing hospitalization, long-term care or an unexpected medical crisis, misunderstanding these rules could have enormous financial consequences.

The second threat concerns what happens to everything you worked so hard to acquire.

Many people believe, “I have a will and a living trust, so my family is protected.”

It may not be that simple.

An estate plan is only as effective as the way it has been structured, maintained and implemented. How assets are titled, whether a trust has actually been funded, beneficiary designations, Medi-Cal eligibility and long-term-care planning can all affect whether a person’s wishes are ultimately carried out.

A will by itself does not automatically avoid probate, and simply possessing trust documents does not mean every asset has been properly protected or positioned to pass as intended.

That is why elders should learn the rules before a medical crisis, incapacity or death makes planning far more difficult.

At the Elder Justice Symposium, experts will explain these changes in understandable language and discuss steps that elders and their families should consider now.

Attendees will have an opportunity to learn what questions to ask about Medi-Cal eligibility and renewals, asset limits, estate planning and protecting the legacy they intend for their families.

Do not assume the rules you learned years ago are still the rules governing you today.

Come to Oakland City Hall on Sept. 25, from 9 a.m. to 5 p.m.

Bring your questions. Bring your family. Most importantly, bring a willingness to prepare.

The decisions you make before these changes take full effect could profoundly affect your health care, your financial security, and what remains for the people you love.