Developed by the Campaign for NY Health and the Black, Puerto Rican, Hispanic and Asian Legislative Caucus, May 4, 2022
This report compiles national and New York State level data to illustrate that health care access is a critical racial equity issue and how systemic solutions like a universal, single-payer health plan will significantly improve health care access and health outcomes for all.
- Download the report
- Download the executive summary
- Watch the livestream of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus and Campaign for NY Health press conference releasing the report
Key findings
Black, Indigenous and People of Color (BIPOC) were disproportionately harmed by COVID-19 due to an unequal ability to access quality, affordable health care and long before the start of the pandemic, were more likely than white people to be uninsured and to struggle with medical costs.
Black Americans are 10% less likely to hold employer-sponsored health coverage than their white counterparts. Having high-quality health insurance is directly related to whether patients seek care.
Many BIPOC work and live in environments that impose higher risks of exposure to COVID-19. Only 17% of Latinx workers and 20% of Black American workers have jobs that permit working remotely, while 30% of white workers can do so.
The U.S. has the highest maternal mortality rate in the industrialized world. Black women are three times more likely – and in New York City, 12 times more likely – to die from a pregnancy-related cause than white women. 63% of these deaths are preventable. Uninsurance and under-insurance are major drivers of the U.S. maternal and child mortality rate.
Public health insurance programs play a major role in providing affordable care and better outcomes, especially for Black Americans.
Insurance coverage increases access to care, but being enrolled in an insurance plan does not guarantee timely care or affordability. Nearly half (46%) of insured adults report difficulty affording their out-of-pocket costs and one in four (27%) report difficulty affording their deductible. About 6 in 10 Black and Hispanic adults (58% each) report delaying or skipping at least one type of medical care in the past year due to cost, compared to half (49%) of white adults. Differences in reimbursement rates between private insurance and public insurance create a disincentive for providers to see lower income patients.
Having health insurance lowers the likelihood of medical debt and the amount owed, but even households with health insurance are at risk of incurring medical debt. 17.4% of households with insurance have medical debt compared to 27.9% of households without insurance. Among those with debt, households with health insurance have an average of $18,827.25, while households without health insurance have an average of $31,947.87.
Black households are more likely to hold medical debt. 27% of Black households hold medical debt compared to 16.8% of non-Black households. Medical debt can appear on a person’s credit reports and lower their credit scores, reducing access to credit and making it harder to find a home or a job.
Communities with majority Black and Latinx residents experience provider shortages more than other communities all over the country. Unequal reimbursement rates lead to disparities in access to hospitals and providers.
Polling consistently shows that voters across race and party lines support systemic change to address shortcomings in the health care system. New York voters overwhelmingly see government as the key stakeholder that should act to address health system problems and support measures to make health care affordable and accessible.
Conclusion
A universal system of publicly-funded, guaranteed health care, often referred to as “single-payer health care,” is the most equitable and affordable way to achieve comprehensive coverage for all. Universal single-payer health care will end the burden of medical debt that disproportionately harms BIPOC communities by eliminating cost-sharing – the out-of-pocket costs such as copays that act as financial barriers to care. Bringing all residents into a single public plan would eliminate the inequity in access that results from a fragmented system. Campaign for New York Health recommends universal single-payer health care as a policy intervention to create a health system that promotes racial equity and quality care for all.