Racial and Ethnic Disparities Remain in Health Insurance Coverage Among Adults Ages 50 to 64

While the Affordable Care Act (ACA) led to widespread gains in health insurance coverage and health care access among adults ages 50 to 64, racial and ethnic disparities in coverage and access remain, and they cannot be fully explained by factors like income and employment.

Disparities could point to other barriers to health insurance coverage, including around eligibility criteria, enrollment processes, health literacy, awareness of coverage options, and systemic social issues. Continuing to make progress in narrowing racial and ethnic disparities in coverage will likely require approaches such as targeted outreach and enrollment efforts among underserved communities, reducing costs associated with health insurance beyond premiums, and provider training and education. At the same time, policymakers will need to work across sectors to address longstanding differences in the underlying social and economic conditions in which people live that impact disparities in health coverage, access, and outcomes.

This report  includes national data on racial and ethnic disparities in coverage and access among older adults, from 2012 (two years prior to the implementation of the ACA) through 2021, the eighth full year of Marketplace operations.* Access measures include having a usual source of care or delaying or canceling care due to cost.

The interactive data visualizations below include health insurance coverage data by state. Users can filter data for each visualization by state, year*, age category, and racial/ethnic group.

* Two data notes: 1) Health insurance data from 2020 were not included in this analysis because the COVID-19 pandemic impacted the collection of the Census Bureau’s health insurance survey data that year. 2) Time-limited policy actions taken during the COVID-19 era likely increased the availability and affordability of health coverage.