Disengaging Disparities: The Effects of Medicaid Expansion on COVID-19 Health Outcomes for Marginalized Populations

Abstract

In January of 2020, America found itself faced with its first official case of the novel SARS-COV-2 virus; by the end of the same month, both the World Health Organization and the Department of Health and Human Services would officially declare COVID-19 a public health emergency and, eventually, a global pandemic. Now, over one year later, America continues enduring the devastating virus that claimed more than half a million American lives, left over 32 million infected, and upturned the national economy. In May of the same year, America witnessed the murder of George Floyd by former Minneonapolis police officer Derek Chauvin and was forced to face a pandemic that had long been spreading under the surface: systemic racism. These two pandemics would quickly cross paths as it soon became unbearably evident that people of color were catching and dying from COVID-19 at an alarmingly higher rate than White people. These disparities opened the door to a larger conversation that America seemed to already be headed towards: deep-rooted systemic racism has been embedded in every aspect of American society, and health and health caare are unfortunately no exception. These racial health disparities relate deeply to the current Congressional war over Medicaid and Medicaid expansion. Only 12 states remain that have elected not to expand their Medicaid programs, and in the midst of a global pandemic affecting marginalized populations that also comprise a large proportion of the Medicaid and expansion-eligibility population, the need for the increased coverage offered by expansion is stronger and more dire than ever. Through quantitative multivariate regression analysis of COVID-19 mortality and case positivity data in Virginia and North Carolina, this thesis seeks to determine whether Medicaid expansion has any effects on COVID-19 health outcomes across different race and ethnicity groups. While no statistically significant association was observable between a state’s Medicaid expansion status and COVID-19 health outcomes, the results did indicate an association between COVID-19 health outcomes and race/ethnicity, as well as Medicaid enrollment and race/ethnicity. Although Medicaid expansion alone isn’t enough to reduce racial health disparities, denying Medicaid expansion coverage to those who currently don’t benefit from it or removing it for those who do would only widen these disparities immensely. If America wishes to work towards true racial and health equity, then health policies relating to expanding insurance coverage and diminishing disparities must be enacted in the recovery process to come.