Beyond Health Insurance: Remaining Disparities in US Health Care in the Post-ACA Era

摘要

In a national survey of approximately 8,000 adults in 2015, we found large income- and race-based disparities in perceived health care quality, affordability, and use of emergency departments. Lack of health insurance is one factor that contributes to worse health care experiences among lower-income Americans and racial/ethnic minorities, but it only explains a small to moderate portion of these disparities. While the Affordable Care Act has led to significant improvements in health care access and affordability, large gaps remain. Repeal of the law would undo much of this progress, but even if the law remains in effect, policymakers need to address other social determinants that contribute to ongoing income- and race-based disparities in health care.