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How Medicaid Cuts Would Hurt People of Color: A State-by-State Breakdown

A woman poses for a photo in Chicago, January 30, 2017.

A new Center for American Progress analysis finds that approximately 8.7 million people of color would lose Medicaid coverage by 2026 under the Senate health care plan. This includes 2.85 million black people, 4.65 million Hispanic people, and 1.2 million other Americans of color, including Asian Americans, Pacific Islanders, American Indians, Native Hawaiians, Alaska Natives, and persons of two or more races.

From asthma and diabetes to HIV/AIDS and breast cancer, people of color suffer from a wide range of health disparities. They also experience higher uninsured rates, although in recent years millions have gained coverage under the Affordable Care Act. Today, one in five adults of color and more than half of children of color have coverage through Medicaid. However, the latest version of the Better Care Reconciliation Act seeks to undo this progress by slashing Medicaid for some of the most vulnerable members of society.

The table below shows state-by-state breakdowns of the estimated number of people of color who would lose Medicaid coverage by 2026 under Senate Republicans’ Better Care Reconciliation Act. (see Methodology)


The authors’ calculations of state-level estimates of Medicaid coverage loss by race and ethnicity are based on Emily Gee’s June 2017 estimates of overall state-level health insurance losses under the Better Care Reconciliation Act. The authors also used state-level data on Medicaid enrollment in 2015 for nonelderly people from the Kaiser Family Foundation—the most recent data available. The authors applied the current distribution of Medicaid coverage by state and race and ethnicity to the projected losses from Gee’s column to produce estimates for the number of people of color in each state who would lose coverage.

This analysis makes several assumptions. First, it assumes that the current racial and ethnic distribution of coverage will mirror the racial and ethnic distribution of loss of coverage by 2026. Second, it assumes that the current distribution of coverage will not change significantly in the next 10 years. While it is possible that the portion of Medicaid recipients will become increasingly white over time, there is little evidence to suggest that current trends will significantly reverse in the coming years. People of color are also a growing portion of the total U.S. population, and by 2044, they will constitute a majority of the country’s population. Unless income disparities are reduced significantly in the next 10 years, it is reasonable to assume that people of color could constitute an even greater portion of Medicaid-eligible Americans in 2026. If this assumption holds true, this analysis produces a conservative estimate for projected loss of Medicaid coverage by race.

It is worth highlighting that projected losses in coverage by racial and ethnic group are not available for some states. This is because estimates with relative standard errors greater than 30 percent are not provided in the Kaiser Family Foundation data. However, this does not mean that members of those racial and ethnic groups will not lose coverage in certain states under the Better Care Reconciliation Act. On the contrary, this produces conservative estimates for the total number of non-white Medicaid recipients who will lose coverage.

Michele Jawando is the vice president for Legal Progress at the Center for American Progress. Connor Maxwell is the research associate for Progress 2050 at the Center.