On the campaign trail in 2016, Donald Trump famously asked America's black voters to support his candidacy, saying, "What the hell do you have to lose?" The answer, it turns out, is health insurance.
A new analysis from the Center on Budget & Policy Priorities finds that African Americans could be disproportionately affected by the Republican plan to repeal and replace the Affordable Care Act. According to the report, more than one-third of African-Americans currently get their health insurance through Medicaid and 1 in 10 of them would lose coverage under the GOP plan.
The ACA allowed states to expand the number of people eligible for Medicaid to any individual or family making up to 138% of the federal poverty line. The Republicans' replacement plan would roll back that provision over a number of years. The nonpartisan Congressional Budget Office found that the bill could cause 24 million people to lose their health insurance over a decade, many of which as a result of the decision to roll back Medicaid.
Ironically, the ACA's Medicaid expansion has underserved African-Americans, who disproportionately live in states that chose not to expand Medicaid. Still, the ACA dramatically improved health care coverage for African-Americans.
In states that did expand Medicaid, working-class African-Americans have seen a significant amount of the benefit. For instance, the CBPP analysis points out that, in Ohio, African-Americans make up 25% of the expanded Medicaid population, despite being just 12.7% of the states total population.
The ACA also brought the national rate of African-Americans who have health insurance up to 88% — within 3% of the coverage rate for all Americans. According to CBPP's analysis, that gap could start to widen again under the Republicans' health care plan.