African American Children : It Is Not The Case For All Children

As of 2008, there are approximately 73.9 million children living in the United States. Of these children more that 5.5 million have some form of mental or physical disability. In addition, 77 percent of uninsured children come from low-income families (CoverTheUninsured.org, 2008). However, Missouri’s population of uninsured children fares much better at almost half the national average or 7.2 percent (Missouri Foundation for Health, 2004). More than 8 million children in America are uninsured. That means 1 out of every 10 does not have any form of health coverage. Racial and ethnic disparities among those uninsured children are dramatic. Most recent data has found that one in 13 White children is uninsured compared to: one in five American Indian children, one in six Latino children, one in nine African American children, one in nine Asian/Pacific Islander children. (Children’s Defense Fund, 2010)

With this increased research and effort, Americans would be able to intervene and make positive impacts with the state, tribal, and local levels to best address health disparities and inequalities. In efforts to thwart ethnic and minority disparities, The Department of Health and Human Services (HHS) passed the HHS Disparities Action Plan in order to establish “a nation free of disparities in health and health care, (Cooper 97)” and to implement a series of priorities, strategies, actions, and goals to achieve this vision. States, local communities, private organizations, and providers have additionally engaged in efforts to reduce health disparities. With the HHS Disparities Action Plan, the Department continuously assess policies and programs on racial and ethnic health disparities, watching to see which policies make an impact on the level of health care received by minorities. Similarly, The Affordable Care Act (ACA) health coverage expansions significantly increase coverage options for low and moderate income populations and particularly benefit the “vulnerable populations.” The ACA also includes provisions to strengthen the safety-net delivery system, improve

Medicaid is a social health care program that covers nearly 60 million Americans, including children, pregnant women, seniors, parents and individuals suffering with disabilities. Medicaid is the biggest source of funding for health related services and medical needs for the people with low income in the United States. This program is funded jointly by the state and federal level governments, but it is the state’s responsibility to manage this program. The Medicaid program is not a required program that states have to use, but all 50 states have implemented this program. With the introduction of the Affordable Care Act (ACA), and its passing in 2010, the ACA unveiled its plans to expand Medicaid eligibility to nearly all low-income adults as an addition to the other groups that fall into the Medicaid eligibility. The Medicaid program had “many gaps in coverage for adults” because it was only restricted to the low income individuals and other people with needs in their own specific category. In the past, the majority of the states who had adults that did not have children dependent on those parents were not eligible for Medicaid. These low income adults without dependent children would be without medical insurance assistance before the ACA was introduced. Medicaid is now available to all Americans under the age of 65 whose family income is at or below the federal poverty guideline of “133 percent or $14,484 for an individual and $29,726 for a family of four in 2011” (NSCL).

Health Care reform is a major topic of discussion in today’s society, especially with the relatively novel release of the Patient Protection and Affordable Care Act (ACA) by the Obama administration. Historically, the health care system has disproportionally favored those of higher class and income, resulting in diminished health care for those that could not afford it. The Institute of Medicine’s (IOM) 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, states that a lack of insurance substantially contributes to the proliferation of healthcare disparities. Furthermore, racial and ethnic minorities are most subject to these healthcare disparities because they are significantly more likely to be uninsured. (1) The history of health care reform in the United States, as it pertains to under-insured urban populations, will be discussed, with a specific emphasis on its impact on African-Americans; in addition, the modern resolutions to healthcare disparities will be assessed.

The overrepresentation of African American children in the foster care system is a major issue in the United States. African American children only represent about fourteen percent of the child population in the United States, yet represents for thirty percent of the children in the foster care system (Lorthridge, 2011). Ards (2012) stated that African American children are one and a half times more likely to be involved with child protective services and two times more likely to be placed in an out-of-home placement compared to any other race. Being a minority in a country, but the majority in an institution, such as foster care, is a significant problem. Not only is the overrepresentation of African American children a matter of question, but their experience while in foster care is concerning as well. African American children are overrepresented at every aspect in the foster care system and the numbers are not decreasing. According to Anyon (2011), African American children are overrepresented at every stage/decision point in the foster care system. The five stages are known as the five key decision points, which are, report of abuse and/or neglect, referral of report for investigation, reunification, out-of-home placement and termination of parental rights, and exiting the foster care system (Harris, 2008).

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

Health disparities endure tenacious issues in the United States of America, setting certain groups at higher risk of being uninsured, limited access to care, facing a poorer quality of care, and overall negative health outcomes. The high incidence of health disparities reflects the range of individual, social, economic, racial/ethnic and environmental magnitudes. Among the minority groups, African-Americans disproportionately access health care and the health disparities clearly glow in the nationwide.

Socioeconomic status is a health disparity in the United States. In 2012, McHenry concluded that there are approximately 84,000 preventable deaths that occur each year. Although the ACA has provided accessible health care to many people that would otherwise not be able to afford health insurance there still is a large population uninsured (Brown & Divenere, 2017). African Americans have a high prevalence of

The disparities are around us every day and unless we educate ourselves and our communities these disparities will continue to wreak havoc on our neighborhoods and in the future, we will just be putting our kids and their kids in a continuing cycle of ignorance when we could have done more if it’s just educating the community we leave in, that alone could be enough to turn the tides in our people favor. In turn, I would hope this paper enlighten you on what is going on in our neighborhood and what we can do to correct this issue to preserve our autonomy. Racial and ethnic health disparities undermine what a healthcare system should stand for. Although the top three causes and seven of the 10 leading causes of death are the same for African Americans and whites, the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites (MMWR, 2005). Health disparities refer to differences in disease risks, incidence, morbidity, and mortality but most of all for the sake of this paper unequal access to quality health insurance amongst African American in the United States, which will also go hand and hand with the social and economic disadvantages. The disadvantages of health disparities usually affect people of African American descent who have systemically experienced a greater social and economic obstacle to health care.

Healthcare disparities within racial minority groups are an ongoing issue in the United States. Factors that affect these disparities are overall quality of care, access to healthcare, and access to insurance. Numerous efforts have been made to decrease the access and quality of care for minorities. The current intervention being used is the Affordable Care Act (ACA). This act was initiated by President Obama in 2010 and has had much controversy in the past years. The main arguments are the ACA increasing the taxes for Americans and the fact that all Americans must obtain insurance if proper funds are available. In 2014 the ACA Medicaid expanded and each state had the opportunity to expand if the state believed it appropriate. Out of the 50

Before the ACA was passed, all states decided to raise the eligibility for children under Medicaid and Children Health Insurance Program (CHIP). North Carolina raised the Medicaid FPL for families with children greater than 6 years old up to 216% (Milstead, 2013, p. 203). However, now that North Carolina has not chosen to expand the Medicaid program non-disabled adults are limited to 43% FPL and childless adults are ineligible (Kaiser Family Foundation, 2014). Those not eligible for Medicaid and CHIP that have incomes between 100% and 400% FPL may be entitled to tax credits if they purchase insurance in the marketplace (Kaiser Family Foundation, 2014). This raises another problem in North Carolina’s uninsured population. The ACA is written by the principal of low income people receiving coverage through the Medicaid expansion, therefore people below FPL are not eligible for Marketplace subsidies (Healthcare, 2015). North Carolina’s uninsured adult population is around 319,000 which is 20% of the uninsured in the state (Kaiser Family Foundation, 2014). This population qualified for the Medicaid expansion under the ACA and all fall below the FPL and now will remain uninsured.

North Carolina has the highest index of the uninsured population approximately 1.6 million. Being uninsured has a profound impact on the health and well-being of the people. The ACA had a significant impact on the different population categories of North Carolina. According to The Affordable Care Act 2014, Medicaid will cover most low-income people if Federal Poverty Level (FPL) is no greater than 138 percent (Milsted, 2013). The people that have more impact are the children six to eighteen, working parents, nonworking parents, and childless adult. Prior to Affordable Care Act, Medicaid was limited to a specific group of low-income individuals, such as children less than six, pregnant women, elderly and disabled. Childless

Making health care affordable for African Americans as well as other ethnic minorities is major priority seeing as African Americans suffer from the highest rates of a range of illnesses compared to the general population. The Affordable Care Act for African Americans will address inequities and increases access to quality, affordable health coverage, invest in prevention and wellness, and give individuals and families more control over their care than they had in the

Health care is necessary for single African American women. Medicaid is one of the commonly used government benefits. Health insurance is unaffordable for most individuals therefore; a family may go without healthcare insurance without a choice because of the financial burden. According to Shi (2008), “minorities may have lower expectations from the

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States