Fewer uninsured since Obamacare, but disparities remain

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The percentage of adults and children without health insurance declined dramatically in Los Angeles between 2011 and 2015, according to a new report from the LA County Department of Public Health, compiled with assistance from USC.

The sharp decline—from 28.5 to 11.7 percent—spanned racial, ethnic, age, gender and geographic groups of adults 18 to 64 years old throughout the county.  The news was even better for children: The percentage of uninsured dropped to 3.4 in 2015—a clear improvement from 10.1 percent in 2002.

Good news—for now

The county findings are consistent with trends reported in California and nationally. The report notes private insurance coverage declined between 2007 and 2011, and attributes the lack of further decline between 2011 and 2015 to the expansion of Covered California—the state’s health care marketplace—and the improving economy.

The Patient Protection and Affordable Care Act—also known as Obamacare—was signed into law in 2010, and fully took hold in 2014. In addition to providing more private insurance options, the bill expanded Medicaid, the nation’s free low-income health program, to cover millions more Californians than were previously eligible. Today, those individuals may lose parts of their coverage, or get dumped from their insurers, should the ACA get repealed or replaced.

“This report shows that we should be working to extend the benefits of the ACA, not to repeal it,” said Mitchell Katz, director of Los Angeles County Health Agency, in a press release.

Michael Cousineau, USC professor of clinical preventive medicine and a contributor to the report, agreed. “It’s not perfect, but the ACA has gotten us closer to a more equitable health care system,” he said. “Research shows that, even in Los Angeles, more people are receiving life-saving medical treatment, hospitals are facing lower uncompensated care costs and health care spending projections continue to fall.”

The statistics spell good news for LA County, according to Barbara Ferrer, director of the LA County Department of Public Health. “We know that having health insurance coverage is an essential step in ensuring people get the medical care they need, including access to preventive services,” she said in a press release.

Unequal Improvement

While the positive news means more LA residents have access to affordable health care, glaring disparities persist among the uninsured.

Among Latinos, the percent of uninsured adults was nearly three times higher than African American, Asian or white uninsured adults.

In addition, the uninsured adults percentage in the “South Service Area,” which includes Athens, Compton, Crenshaw, Florence, Hyde Park, Lynwood, Paramount and Watts, was more than triple that in the “West Service Area” of Beverly Hills, Brentwood, Culver City, Malibu, Pacific Palisades, Playa del Rey, Santa Monica and Venice.

Numerous USC public health programs in the Department of Preventive Medicine are working to eliminate  health disparities at the local, state, national and global levels, including the USC Institute for Global HealthUSC Environmental Health CentersImmigrant Health InitiativeCenters for Health Equity in the AmericasInstitute for Health Promotion & Disease Prevention Research and the Program on Global Health & Human Rights.

In the classroom, Cousineau is teaching his Master of Public Health students about the ACA debate—and even took 18 to Sacramento in February to meet with legislators and attend a health reform conference.

“In order for us to continue our work to minimize health disparities and inequity, policymakers need to protect the gains we’ve already made,” Cousineau said.

Photo: A representative from L.A. Care Health Plan, a public agency that provides health coverage to low-income Los Angeles County residents, speaks to USC students and alumni Mar. 24 at a career fair hosted by the Department of Preventive Medicine.

 

— by Larissa Puro


Michael Cousineau is the  director of the USC Master of Public Health program’s Health Services and Policy TrackInterested in learning more about health services and health policy education at USC?  Learn more about our MPH programs »