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Medicare and Medicaid: Achieving Health Equity In America | Commentary

Fifty years ago, President Lyndon B. Johnson signed the Medicare and Medicaid programs into law, bridging the health insurance gap faced by many older and low-income Americans struggling to afford coverage. For African-Americans, a population that has historically suffered disproportionately from adverse health conditions, these programs have been vital in expanding access to care.

Today, 10 percent of the more than 54 million people enrolled in Medicare are African- American. In the Medicaid program, roughly 21 percent of beneficiaries, or 11 million enrollees, are African-American. In many respects, the need for increased access to quality, comprehensive health care is as great in the African- American community today as it was 50 years ago.

African-Americans are at or near the top of virtually every negative health indicator. From cancer to heart disease and a host of afflictions in between, African-Americans often have both higher instances of illness and higher mortality rates. Yet African-Americans have faced significant financial constraints in access the care we need to reverse these negative health trends.

According to a survey conducted by the Urban Institute, minority Medicare beneficiaries have higher rates of poverty than whites, with 65 percent of African-American Medicare beneficiaries below 200 percent of the poverty line, compared to 41 percent of whites. Underscoring the need for Medicare in the African- American community, the same study concluded that 43 percent of African-American Medicare beneficiaries are in poor health, compared to 26 percent of whites.

For older African-Americans — a group more likely to have lower-paying jobs and therefore less likely to be able to save for future health care costs — Medicare has been a critical lifeline in their later years. The role of Medicaid in improving the health and quality of life of older African-Americans will grow exponentially as this population is projected to increase by 104 percent in 2030, according to the Agency on Aging.

Similarly, African-Americans are less likely to receive the preventative care we need to fend off chronic disease. But thanks to Medicaid, more African-Americans have access to the health screenings that are key to the early detection and treatment of illness that improves health outcomes and reduces health costs.

In tandem, Medicare and Medicaid — with important expansions in coverage through subsequent legislative efforts such as the Affordable Care Act — have made great strides in promoting health equity in America. Yet while many states have expanded Medicaid through the ACA, the states that have elected not to expand coverage continue to exacerbate health disparities, disproportionately affecting poor African-Americans. Currently, there are 2.9 million African- Americans nationwide without coverage as a result. Medicaid expansion would ensure coverage to six in 10 uninsured African-Americans.

From the desegregation of health delivery centers to the improvement of overall health outcomes, Medicare and Medicaid have been critical in reducing health disparities in the African-American community. As chairwoman of the Congressional Black Caucus Health Braintrust, I’m committed to preserving these vital social health programs and working to ensure that in the next 50 years, we substantially improve our national health outlook and eliminate health disparities in America once and for all.

Rep. Robin Kelly, D-Ill., is chairwoman of the Congressional Black Caucus Health Braintrust.

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