According to Cara James, director of race, ethnicity, and healthcare at the Kaiser Family Foundation, the billâ€™s expansion of coverage and Medicaid eligibility will have major implications for African Americans who are uninsured by a margin of 1 in 5, compared to whites whose margin of uninsured is 1 in 10. She added that a greater focus on preventive care and cultural competency in providing that care, increased funding for community health centers, and efforts to increase the number of providers that include special student loan repayment plans will be hugely beneficial to minority communities.
Butterfield noted that the Medicaid expansion is a critical reform thatâ€™s been overlooked in the debate. â€śRight now, low-income families qualify, but not individuals. So the cousin or nephew whoâ€™s 31 and single and makes minimum wage and has no health insurance will be able to qualify. That is significant,â€ť he said.
James also believes that the employer mandate will play a big role in expanding coverage to blacks because they tend to work for smaller companies where they earn lower wages and have less access to coverage because it is often too costly for their employers to provide it.
Small businesses with 50 employees or fewer will not be mandated to offer coverage. But those with 51 employers or more will, and they’ll be assessed a $2,000 penalty per employee if they donâ€™t. However, the first 30 employees will be exempted from that penalty.
â€śHopefully a company with 51 employees or more will have the margin in order to provide insurance. Theyâ€™re going to have to anticipate this,â€ť said Butterfield. â€ś[The bill will not be] fully operational until 2014. So smart business people can get ready right now to anticipate this.â€ť
Later this week, Obama will travel to Iowa to continue making the argument for healthcare reform. And, says Rep. Elijah Cummings (D-Maryland), the president would be very wise to continue making such trips.
Like many of his colleagues, Cummings was saddened by the bitterness of the road to reform, which included incidents last weekend of Tea Party members and other protesters spitting and hurling racial epitaphs at black lawmakers, including civil rights icon Rep. John Lewis (D-Georgia).
To Cummingsâ€™ dismay, even after those incidents, Republican lawmakers went out on a balcony overlooking the protesters holding signs that read â€śKill the bill.â€ť
â€śIt seems to me that thereâ€™d be a level of sensitivity where theyâ€™d say maybe we need to tell these folks to chill out, that this is the last thing we should be doing,â€ť said Cummings. â€śThatâ€™s why Obama has to continue to ride the horse that brought him [to office], because when he gets off and lets anything else get in between, he loses the power that the people gave him.â€ť
For now, with this win under his belt, Obama has essentially reestablished his presidency, said Larry Berman, a University of California-Davis political scientist.