Objectives. To examine health insurance disparities since Kentucky's implementation of the Affordable Care Act (ACA). Methods. Using the American Community Survey, we estimated coverage rates by race/ethnicity before and after implementation of the ACA (2013 and 2015), and we estimated whether groups were over- or underrepresented among the uninsured, compared with their share of the state population. Results. Kentucky's uninsurance rate declined from 14.4% in 2013 to 6.1% in 2015 (P < .001). Uninsurance rates also declined for most racial/ethnic groups, including Blacks (16.7% to 5.5%; P < .001) and Whites (13.3% to 5.3%; P < .001). In 2015, Blacks were no longer overrepresented among Kentucky's uninsured, with a significant decline in the ratio of Blacks among the state uninsured population compared with their share of the state population (1.16–0.91; P = .045). Conclusions. In Kentucky, which mounted a robust implementation of the ACA—in-cluding Medicaid expansion, a state-based marketplace, and an extensive outreach and enrollment campaign—the state experienced not only a decline in the overall uninsurance rate but also an elimination in coverage disparities among Blacks, who historically were overrepresented among the uninsured.
PubMed: MeSH publication types
- Journal Article
- Observational Study
- Research Support, N.I.H., Extramural