Will national health reform close ethnic and racial disparities?

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National health reform is designed to help everyone who lacks medical coverage, but minority groups stand to benefit most — simply because they have the farthest to go.

One-third of Hispanics and more than 20 percent of African-Americans nationwide lack health insurance. But the law’s provisions — most of which take effect in January 2014 — will effectively cut by half the number of African-Americans who are uninsured, and significantly improve coverage rates for Hispanics.

“I think it’ll have the biggest impact in terms of reducing disparities in this country of any piece of legislation since the Civil Rights Act,” says Robert Restuccia, executive director of Community Catalyst, a Boston consumer advocacy organization that operates in 40 states. “I’ve worked 30 years on this stuff and there’s not anything [else] that even comes close.”

The benefits go beyond basic coverage. The federal Affordable Care Act — unlike Massachusetts’ 2006 health overhaul — provides preventive measures for free. That means no out-of-pocket costs for diabetes, HIV, and cholesterol screening, dietary counseling, immunizations, and mammograms.

 

Dr. Carl C. Bell, a Chicago psychiatrist long involved in the fight for equal care, says the focus on prevention will profoundly improve the quality of health care for nonwhites.

“If you look at the history of polio, there were enormous disparities regarding care,” he says, citing one example. “But when the polio vaccine came out, sooner or later, everybody got the vaccine.”

Comprehensive coverage is equally crucial, says Dr. Pano Yeracaris, chief medical officer and vice president of Network Health, a nonprofit insurer of low-income Massachusetts residents. It doesn’t much matter if someone has health insurance if they can’t afford to use it, or can’t find a doctor to see them, Yeracaris says.

In Massachusetts, health insurance reform provided this kind of substantial coverage, he says, as shown by the increased number of visits to primary care doctors after the law was enacted.

Part of Massachusetts’ success lies with its network of community health centers, which has been expanding over the past six years. Mattapan Community Health Center opened a new building in August, allowing it to double its capacity, says Azzie Young, the center’s executive director. It also offers on-site dental care and mammograms, removing more barriers for clients who might not have the time or means to travel far from home to more than one facility.

For Young, another crucial piece of the Affordable Care Act is its extension of coverage to people with preexisting conditions, and a provision — already in place — that allows children up to age 26 to be included on their parents’ plans.