Without question, health insurance access makes a major difference in when and how people receive the medical care they need. Historically, patients at a social or economic disadvantage have systematically faced greater challenges when it comes to achieving optimal health.
Medicaid is specifically designed to bridge the gap for optimal medical care for individuals with economic and social disadvantages by providing health insurance coverage. Nevertheless, health disparities have shown little improvement over the last decade, even with greater access to Medicaid coverage.
Health disparities exist for Medicaid recipients, especially those with limited-English proficiency (LEP). Below is a closer look at the health disparities among Medicaid recipients, the demographics of Medicaid recipients in most states, and how care providers can better achieve health equity for all Medicaid recipients.
Demographics of Medicaid Recipients
Medicaid plays a major role in covering specific groups of people. Predominantly, the insurance covers adults and children of color. As of 2020, Medicaid covered three of 10 Black, Native Hawaiian and Other Pacific Islander (NHOPI), and American Indian and Alaskan Native (AIAN) non-elderly adults. In Hispanic populations, two in 10 non-elderly adults were Medicaid recipients. By contrast, only 17% of non-elderly White adults had Medicaid coverage.
Medicaid covers even more children: half of Black, Hispanic, and AIAN children have coverage, and almost half of NHOPI children have coverage. By contrast, only 27% of White children are covered by Medicaid.
The latest research also indicates that at least 12% of the entire population covered by Medicaid are LEP individuals over the age of five. This represents around 5.5 million LEP individuals that may not be able to take full advantage of care even with Medicaid coverage because of language barriers.
A Closer Look at Health Disparities Among Medicaid Recipients
Lack of insurance drives health disparities significantly. Minorities are less likely to have health insurance at all. However, even those covered by Medicaid don't always achieve the same standards of care. For example, LEP patients don't often take full advantage of their health coverage due to a lack of language access and a general lack of understanding of their care options.
In April 2021, the Medicaid and CHIP Payment and Access Commission published a fact sheet that provided insight into health disparities among Medicaid recipients. Some of the most noteworthy health disparities included:
- Lack of access to care in spite of Medicaid coverage, especially for Hispanic children
- Problems with access to providers that accept Medicaid
- Issues with access to care for specific but common conditions, such as asthma
- Lack of taking advantage of oral care programs
- Higher rates of maternal morbidity among women of color
Quite a few factors contribute to the lack of health equity, including economic status, potentially making it difficult to get to a provider. However, lacking language access is no doubt involved. In one study published in 2000, language barriers were highly associated with children not receiving timely care in spite of being covered by Medicaid.
Taking Steps Toward Health Equity for Medicaid-covered Patients
To achieve health equity for all Medicaid recipients, care providers must advocate for change. This means embracing the objectives set forth by the U.S. Department of Health and Human Services (HHS) Disparities Action Plan. This strategic, comprehensive plan offers a guide to addressing health disparities through a coordinated framework. The HHS calls out a number of objectives, such as:
- Collecting research and data to better understand health disparities and the roles race, language, and ethnicity play
- Enhancing cultural competence among healthcare providers to better patient-provider relationships
- Bridging the perceived gap between knowledge of minority populations and practice in care scenarios with knowledge and innovation
Several steps can help care providers ensure that all Medicaid patients have access to the best care possible. Cultural competence training for staff and enhanced language access with interpretation services are two good examples.
Final Thoughts on Health Equity for Medicaid Recipients
Even though Medicaid is important to address disparities in healthcare due to race and socioeconomic status, broader efforts are just as important. Disparities remain in spite of Medicaid coverage for minority populations. When these issues are not addressed, patients are still at greater risk. Unfortunately, without change, health equity issues are bound to persist.