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ACA Closes Health Care Gap for Asian Americans

Medicaid expansion states provide a strong boost in providing access to care.

A young Asian-American woman wearing glasses looks to the side

Agung Rusdy/Unsplash

The Affordable Care Act (ACA) has helped reverse inequities in insurance coverage for Asian Americans. In the past decade, the gap in health insurance coverage between Asian Americans and white Americans closed, according to a Commonwealth Fund report.

In 2010, Asian Americans — the fastest-growing racial or ethnic group in the U.S. — were more likely than whites to be uninsured. At the time, nearly 20% of Asian Americans between 19 and 64 lacked insurance, compared to 15% of white Americans, according to the American Community Survey. By 2017-18, Asian Americans’ uninsured rate fell to 7.9%, lower than the 8.5% uninsured rate for white Americans — and a lower rate than any racial or ethnic group in the country. Since the ACA’s passage, the coverage disparity between Asian Americans and whites was eliminated across all income categories.

“The combination of Medicaid expansion and improving marketplaces has dramatically improved coverage among whites and people of color,” Sara Collins, one of the authors of the Commonwealth Fund study, told The Hill.

While the uninsured rate fell among all races and ethnicities after implementation of the ACA, disparities remain. Almost a quarter of Native American and Latino populations and over 14% of Black Americans still lack insurance, for example.


One possible reason for Asian Americans’ increased coverage: Many live in Medicaid expansion states, which has helped drive down their overall uninsured rate. Only 6.5% of Asian Americans living in expansion states do not have insurance, compared to 12.3% in non-expansion states. Progress also varies among Asian American subgroups: Koreans had the highest uninsured rate, followed by Vietnamese, while Chinese, Filipinos and Indians were more likely to be insured, with a subgroup-low 5.4% uninsured rate among Indian Americans.