Across the United States, health insurance coverage varies. In fact, the differences in policies and covered medical procedures and treatments are about as varied as the states themselves!
Among Black Americans especially, these disparities in health insurance coverage are more pronounced than ever. Some plans protect you in case of severe health conditions or events, while others leave you completely hung out to dry. In some cases, the language in your plan may be so vague, you don’t even know if you’re covered.
But here’s the good news. One of the main reasons for sub-par health insurance is as clear as day. The answer? Your job.
You May Also Like
From part-time work to service sector employment, many jobs held by Black Americans are not delivering the health insurance coverage people need and deserve. Now, while these systemic challenges are complex and complicated, that doesn’t mean they can’t change.
Let’s break that down and offer some possible solutions that could change the insurance game.
RELATED: Health Insurance Mistakes Black Folks Should Avoid in 2025
You May Also Like
Understanding The Employment Gap
Many people don’t realize just how much their job affects the type of health insurance they can access. For many Black Americans, obtaining employer-sponsored health insurance is the first barrier. According to the U.S. Census Bureau, a large number of Black workers are employed in part-time, temporary, and service-sector jobs.
In many cases, these positions do not offer employer-provided health insurance benefits.
Because of this, many Black workers face sky-high out-of-pocket healthcare costs. In some cases, they don’t have health insurance at all.
Research from the Economic Policy Institute helps explain this issue. Data shows that many Black workers are overrepresented in jobs that pay low wages, lack stability, and are not eligible for health benefits.
Another area of concern is that of service-sector jobs. In most cases, these jobs are also low in pay while still requiring significant time commitments. Many also have high turnover rates, which is why employers are reluctant to provide health insurance benefits. From retail to food services, these job sectors typically provide little to no affordable healthcare coverage.
As the Bureau of Labor Statistics (BLS) finds, only a small percentage of Black workers in these part-time and temporary roles receive benefits. Because of this, employees are forced to look elsewhere for health insurance, which usually means Medicaid or private market insurance.
In the case of private market insurance, it can be quite costly.
RELATED: Building Generational Wealth: The Role of Life Insurance in Black Families
What Causes This Employment Gap?
There are many theories, supported by evidence, on why this employment gap is so wide. One of the main reasons Black Americans are overrepresented in underinsured sectors and jobs is because of socioeconomic disparities.
Many Black workers may come from backgrounds where educational and vocational opportunities are lacking. They may be trapped in unsafe and unhealthy urban environments that are undeveloped. Many inner cities are boarded up, with businesses leaving and present employers cutting corners to make a profit.
Add in discriminatory hiring practices, and it becomes difficult to make a decent living. Without adequate income and high-paying jobs, the problem is twofold. Not only are these individuals working jobs that won’t provide health insurance, but because the jobs pay so little, these workers couldn’t afford insurance elsewhere if they tried.
Another issue is the fact that Medicaid is not universally available. The states that don’t have Medicaid present a unique problem to Black employees. In many cases, these workers may earn too much to qualify for Medicaid, but not enough to get private insurance. It’s a catch-22 and can be a serious problem for those trying to ascend to success.
RELATED: 5 Things You Need to Know Before Purchasing Long-Term Care Insurance
But Here’s What Can Be Done
As you can see, there are many factors at play here, so finding a quick and easy solution is virtually impossible. However, that doesn’t mean that certain glaring problems can’t be resolved. The truth is, there is no one-size-fits-all. The answer to many of these issues incorporates various elements. These include changes at the policy level, employer incentives, and community-centered interventions that encourage upward mobility in affected sectors.
To expand healthcare access to marginalized communities, a first step should be broadening Medicaid availability. This is one way to reduce the number of insured people in low-income jobs. In many states, Medicaid has expanded to help people who make up ~140% of the federal poverty cutoff.
Unfortunately, several states have not made this move, leading to economic disparity.
If these states can get on board (which would boost their economies), the next step should be addressing employers directly. Part-time, temporary, and service-sector jobs are where the problem is most pronounced. To get these workers the benefits they need, mandates and other legislative actions may be necessary.
Businesses can also be incentivized through various tax breaks and subsidies which will not only encourage health insurance coverage but may also attract and retain more workers. With an improved economic engine, businesses are more likely to offer flexible hours, job security, and unique pay structures.
Another way to address insurance disparities is through access to better education. Some Black workers may simply be unaware of their rights. They may not realize that there are available programs they can use to greatly ease their burden.
Whether it’s through advocacy networks, seminars with health professionals, or community-run events, residents of underserved communities deserve to know what they don’t know!
For instance, how many people don’t know how to navigate the insurance marketplace? How many don’t know what health risks and outcomes they should be most concerned about? How many people don’t know how to make changes to their plans or find alternative plans that aren’t openly advertised or promoted?
Last but not least, there is the issue of community safety. Although business incentives are nice, some businesses may close up shop and move elsewhere if they find the community unsafe. Local activism and community centers can help steer people on the right path from a young age. This can set the youth on a track for success once they graduate high school.
And if the community environment becomes safer, then larger, more prestigious companies may move into town, offering better jobs with better health insurance coverage.
Overall, the issue is multifaceted and complex. However, that doesn’t mean that it can’t be solved one piece at a time. From on-the-ground efforts to high-level changes at the legislative level, helping underserved communities requires a full-on approach.
With a concerted, continuous, and transparent effort, success may only be a matter of time!
