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Health Equity

Medicaid can and should play an active role in advancing health equity, in particular addressing racial and ethnic disparities in health care and health outcomes. More than 57 percent of adults enrolled in Medicaid and more than 67 percent of children enrolled in Medicaid and the State Children’s Health Insurance Program (CHIP) identify as American Indian and Alaska Native (AIAN), Asian American and Pacific Islander (AAPI), Black, Hispanic, or multiracial (MACPAC 2022).

Health equity is commonly defined as a concept in which “everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care” (Braveman et al. 2017).

Medicaid beneficiaries, who are often marginalized for their race, ethnicity, age, disability, sex, gender identity, sexual orientation, and geography, may experience inequities and disparities in access to coverage and services, as well as health outcomes. While Medicaid alone cannot remedy societal health inequities or their causes, applying a health equity lens to its policies may help reduce these disparities and inequities in access to care, health care experiences, and health outcomes among the people it serves.

MACPAC has committed to embedding a health equity lens across all of its work. For example, the Commission recommended extending postpartum coverage from 60 days to a full year to address the high rates of maternal morbidity and mortality especially for people of color, changing estate recovery policies to mitigate their disproportional effects on the most vulnerable, and strengthening the role of Medicaid in serving both child and adult beneficiaries with behavioral health needs. We also examine disparities in access and barriers to care for beneficiaries of color in other publications.

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Featured Publications

Medicaid Demographic Data Collection

June 17, 2024

Chapter 4 looks at the collection of demographic data in Medicaid. Medicaid plays an important role in providing health insurance coverage to historically marginalized populations, and disparities in health care access and outcomes persist among these populations. However, gaps in demographic data collection can impede efforts to measure and address these health disparities.
As a continuation […]

Medicaid Demographic Data Collection

April 10, 2024

Racial and ethnic health disparities persist throughout the U.S. health care system. Measuring differences in access and use of services, as well as experience and satisfaction of behavioral and mental health care, can help to better understand the underlying causes of disparities. This work is a continuation of the Commission’s March 2024 recommendations for improving […]

Engaging Beneficiaries through Medical Care Advisory Committees to Inform Medicaid Policymaking

March 15, 2024

Chapter 1 examines the role of Medical Care Advisory Committees (MCACs) in supporting state Medicaid agency efforts to incorporate beneficiary voice into their programs. Beneficiaries can provide feedback to policymakers on the issues that affect their access and use of Medicaid-covered services. Federal rules mandate that every state Medicaid agency operate an MCAC that consists […]