ABSTRACT ISSUE: Prior to the Afordable Care Act (ACA), blacks and Hispanics were more likely than whites to face barriers in access to health care. GOAL: Assess the efect of the ACA’s major coverage expansions on disparities in access to care among adults. METHODS: Analysis of nationally representative data from the American Community Survey and the Behavioral Risk Factor Surveillance System. FINDINGS AND CONCLUSIONS: Between 2013 and 2015, disparities with whites narrowed for blacks and Hispanics on three key access indicators: the percentage of uninsured working-age adults, the percentage who skipped care because of costs, and the percentage who lacked a usual care provider. Disparities were narrower, and the average rate on each of the three indicators for whites, blacks, and Hispanics was lower in both 2013 and 2015 in states that expanded Medicaid under the ACA than in states that did not expand. Among Hispanics, disparities tended to narrow more between 2013 and 2015 in expansion states than nonexpansion states. The ACA’s coverage expansions were associated with increased access to care and reduced racial and ethnic disparities in access to care, with generally greater improvements in Medicaid expansion states. KEY TAKEAWAYS The Afordable Care Act has led to a drop in uninsured rates among blacks and Hispanics, narrowing disparities with whites. Between 2013 and 2015, disparities narrowed on three key health care access measures: the percentage of uninsured working-age adults, the percentage of adults who skipped care because of costs, and the percentage of adults who lacked a usual care provider. Disparities were narrower in states that expanded Medicaid under the ACA than in states that did not expand. ISSUE BRIEF AUGUST 2017 Reducing Racial and Ethnic Disparities in Access to Care: Has the Afordable Care Act Made a Diference? Susan L. Hayes Senior Researcher The Commonwealth Fund Pamela Riley Vice President The Commonwealth Fund David C. Radley Senior Scientist The Commonwealth Fund Douglas McCarthy Senior Research Director The Commonwealth Fund