Racial/ethnic disparities in health and health care in the United States are persistent and well documented. Communities of color fare far worse than their white counterparts across a range of health indicators: life expectancy, infant mortality, prevalence of chronic diseases, self-rated health status, insurance coverage, and many others. As the nation’s population continues to become increasingly diverse—people of color are projected to comprise 54% of the U.S. population by 2050 and more than half of U.S. children by 2023— these disparities are likely to grow if left unaddressed. Recent health care reform legislation, while not a panacea for eliminating health disparities, offers an important first step and an unprecedented opportunity to improve health equity in the United States.

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This issue brief identifies, analyzes and compares provisions which explicitly address the health and health care needs of racial and ethnic minorities within the two leading Congressional health care reform proposals: The Affordable Health Choices Act of 2009 (H.R. 3962) passed in the House of Representatives on November 7, 2009; and The Patient Protection and Affordable Care Act of 2009 (H.R. 3590) introduced in the Senate on November 18, 2009, as a merged version of the Senate Finance Committee’s America’s Health Future Act (S.1796) and Senate Committee on Health, Education, Labor, and Pensions’ (HELP) Affordable Health Choices Act (S. 1697). Additionally, this issue brief explores the potential implications of broad health care reforms for racial and ethnic minorities. Also discussed is how each bill could decrease disparities and improve minority health, where each falls short in advancing these goals, as well as the transitional challenges and questions for the future should health care reform legislation be enacted.

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This report examines Senator Barack Obama’s and Senator John McCain’s health care proposals in the context of eliminating the nation’s longstanding racial/ethnic disparities in health and health care.