Of the 6.8 million uninsured African-Americans who are eligible for health insurance through the Affordable Care Act, 60 percent meet the income thresholds for financial assistance to help pay for it, according to a report released this morning by the U.S. Department of Health and Human Services. That’s about 4.2 million African-Americans who qualify for benefits either by way of Medicaid, the Children’s Health Insurance Program (CHIP) or a tax break. Under the Care Act, the limit for how much you can make at work to qualify for Medicaid was raised to expand the pool of people who can receive those benefits. But states can opt out of that Medicaid expansion, and right now roughly half of the states have indicated they will. If all the states cooperated with the Medicaid expansion, then 95 percent of uninsured African-Americans would qualify for assistance. Right now, 20 percent of African-Americans are uninsured compared to 16 percent of the U.S. population in general (who aren’t Medicare-elderly-beneficiaries). 

Of uninsured African-Americans, 39 percent live in just five states: Florida, Georgia, Texas, North York and New Carolina. Interestingly North Carolina, with its population of 9.7 million people — about 2.1 million African American — have more uninsured than New York (population 19.5 million, 3.3 million of whom are black), and California (38 million people, 2.5 million of whom are black).  

One in five uninsured African-Americans live in six cities: Atlanta, New York, Chicago, Dallas, Houston and Detroit. Atlanta has the most uninsured African-Americans with 332,000, but is in a state that doesn’t plan to expand Medicaid. Georgia has the second highest number of uninsured African Americans (631,000) of all states, with only Florida above it. The federal government pays for the Medicaid expansion, but Georgia Gov. Nathan Deal is refusing the federal subsidies. 

Gov. Deal’s decision will cost the state about $4.9 billion in 2022 according to a report from the Commonwealth Fund. Since the Medicaid expansion is funded through our taxes, Georgia taxpayers — and those from all 24 other states that plan to refuse the federal funding — will essentially be paying the Medicaid costs for people in the states that are willing to take the federal subsidies to expand the pool without receiving the same benefits themselves.  

"The health care law is working to address long standing disparities in health care coverage and improve the health of the African-American community," said Secretary of Health and Human Services Kathleen Sebelius in a press statement. "Through the Health Insurance Marketplace, 6.8 million uninsured African Americans have new options for affordable health coverage that covers a range of benefits, including important preventive services with no out of pocket costs."