This paper describes issues that need to be addressed to reform the U.S. healthcare delivery system, the solutions to some of these issues that are part of the Patient Protection and Affordable Care Act (as amended), and the implications for African Americans of some of the recently enacted reforms. These reforms take the first steps toward eliminating the insurance coverage gap that keeps many from receiving needed care. The necessary and simultaneous emphasis on cost containment of this legislation, however, may limit access to health care for African Americans.
Agency for Healthcare Research and Quality [AHRQ]. 2008. National Healthcare Disparities Report.U. S. Department of Health and Human Services, at http://www.ahrq.gov/qual/qrdr08.htm (accessed 20 January 2010).
2.
Center on Budget and Policy Priorities. 2009. Private Health Coverage Declined, Became Less Secure in 2008, http://www.cbpp.org/files/9-10-09health.pdf (accessed 20 January 2010).
3.
Centers for Medicare & Medicaid Services. 2010. “Table 1 National Health Expenditures and Selected Economic Indicators, Levels and Annual Percent Change: Calendar Years 2004–2019.”National Health Expenditure Projections 2009–2019, http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2009.pdf (accessed 30 March 2010).
4.
Commonwealth Fund. 2006. Why Not the Best? Results from a National Scorecard on US Health System Performance, as cited in Joint Center for Political and Economic Studies, United States House of Representatives, Tri-Committee's America's Affordable Health Choices Act of 2009 (H.R.3200) September 2009, http://www.jointcenter.org/hpi/sites/all/files/House_Bill_Analysis_PREP_FINAL.pdf (accessed 20 January 2010).
DavisR.A., CohenL., and RodriguezS.2010. “Toward Health Equity: A Prevention Framework for Reducing Health and Safety Disparities,” in HealeyB.J., and ZimmermanR.S., eds., The New World of Health Promotion: New Program Development, Implementation, and Evaluation.Sudbury, MA: Jones and Bartlett Publishers LLC, at http://www.preventioninstitute.org/index.php?option=com_jlibrary&view=article&id=199&Itemid=127 (accessed 29 January 2010).
HenryJ.Kaiser Family Foundation. 2009b. Distribution of the Nonelderly with Medicaid by Race/Ethnicity, states (2007–2008), US (2008).Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey Annual Social and Economic Supplements, at http://wwwstatehealthfacts.kff.org/comparetable.jsp?ind=158&cat=3&sub=42&yr=134&typ=2 (accessed 22 March 2010).
Joint Center for Political and Economic Studies. 2009. Broadband Imperatives for African Americans: Policy Recommendations to Increase Digital Adoption for Minorities and Their Communities, at http://www.jointcenter.org (accessed 20 January 2010).
LaVeistT.A., GaskinD.J., and RichardP.2009. The Economic Burden of Health Inequalities in the United States, at http://www.jointcenter.org (accessed 21 January 2010).
16.
LeighW.The health of African American women. In: AdamsD.L., editor. Health issues for women of color.Thousand Oaks: Sage; 1995. p. 128.
17.
MartinezM.E., and CohenR.A.2010. Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January-September 2009.National Center for Health Statistics, Division of Health Interview Statistics, http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201003.pdf (accessed 7 April 2010).
U.S. Census Bureau. 2009a. Table POV01. Age and Sex of All People, Family Members and Unrelated Individuals Iterated by Income-to-Poverty Ratio and Race from the Current Population Survey, 2009 Annual Social and Economic Supplement, at http://www.census.gov/hhes/www/cpstables/032009/pov/new01_000.htm (accessed 12 April 2010).
20.
U.S. Census Bureau. 2009b. Table 3: Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origin for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008–03), at http://www.census.gov/popest/national/asrh/NC-EST2008-srh.html (accessed 22 March 2010).
21.
U.S. Congressional Budget Office [US CBO]. 2010. Letter of 18 March 2010 from Douglas W. Elmendorf to Honorable Nancy Pelosi with Cost Estimate of H.R. 4872, Reconciliation Act of 2010, http://www.cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf (accessed 26 March 2010).
22.
U.S. Department of Health and Human Services [US DHHS]. 2009. Health, United States, 2008.DHHS Publication No. 2009–1232, http://www.cdc.gov/nchs/data/hus/hus08.pdf (accessed 27 January 2010).
23.
U.S. Government Accountability Office [US GAO]. 2009. Medicaid: Fraud and Abuse Related to Controlled Substances Identified in Selected States. GAO-09-1004 T Washington, DC:US GAO, http://www.gao.gov/new.items/d091004t.pdf (accessed 20 January 2010).