Unequal Gains? A Literature Review on the Affordable Care Act’s Effects on Healthcare Utilization Across Racial and Ethnic Groups

Abstract

The Affordable Care Act (ACA), implemented in 2010, aimed to expand healthcare access, reduce costs, and address long-standing disparities in the U.S. healthcare system, particularly among racial and ethnic minorities. This paper reviews the ACA’s impact on healthcare utilization for these populations, with a focus on insurance coverage, preventive services, and health outcomes. While Medicaid expansion significantly reduced uninsured rates and increased access to care in states that adopted the expansion, millions of low-income individuals, many of whom are racial and ethnic minorities, remain uninsured in non-expansion states. The elimination of cost-sharing for preventive services under the ACA contributed to increased utilization of cancer screenings, vaccinations, and other preventive measures among minority groups. However, challenges persist, including affordability barriers, geographic disparities, and cultural and linguistic obstacles. This review also highlights the ongoing need for policy interventions, such as nationwide Medicaid expansion, and future research on the long-term effects of the ACA on health outcomes for minority populations.