Commentary, NC Budget and Tax Center

NC’s overall uninsured rate masks stark differences across racial and ethnic groups

The COVID-19 pandemic has highlighted the long-standing inequities in our society, including disparate access to health care among different racial and ethnic groups in North Carolina. Last month, the Census Bureau released 2019 state-level data on health insurance coverage that inform our understanding of the gaps in health care coverage that existed prior to the pandemic.

The North Carolina uninsured rate remains higher than the national uninsured rate of 9 percent, a longstanding gap that has only widened since the state opted not to expand Medicaid — which would have lowered the uninsured rate — following the implementation of the Affordable Care Act’s major provisions in 2014.

The data show that while 11 percent of North Carolinians lacked health insurance, this figure masks the differences across racial and ethnic groups in the state. Except for Asian American and multiracial North Carolinians, the uninsured rate for all non-white racial and ethnic is greater than the state’s overall uninsured rate. The greatest difference can be seen in the 31 percent uninsured rate for Hispanic and Latinx North Carolinians, who represent approximately 10 percent the state’s population.

The uninsured rate for Hispanic and Latinx North Carolinians is substantially higher than both the state uninsured rate and the national uninsured rate for the same group. The high uninsured rate among this group prior to the pandemic, in addition to the essential work that many of them perform that increases risk of exposure, has likely played a role in the higher incidence of COVID-19, with 33 percent of the state’s cases occurring among Hispanic North Carolinians.

Immigrants, including those in the Hispanic and Latinx community, serve vital roles in the fabric of our communities, and yet in many ways have been systematically excluded or marginalized from state and federal actions prior to and in response to the COVID-19 pandemic, as we have written about elsewhere.

Suzy Khachaturyan is a policy analyst wit the N.C. Budget & Tax Center.

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