The Affordable Care Act’s Medicaid expansion increased coverage especially for the “undeserving poor”—nondisabled, nonelderly adults, who disproportionately are African American. However, African Americans benefited comparably less than other groups from Medicaid expansion because they disproportionately reside in states that rejected Medicaid expansion. Psychological and other social science research establishes that disapproval of providing “welfare” to “undeserving poor” is closely aligned with racial bias, and that these sentiments partly motivate public disapproval of policies such as Medicaid for nondisabled, nonelderly adults. It is important to clarify and acknowledge this barrier for a realistic perspective on obstacles to keeping and expanding Medicaid coverage.

中文翻译：

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非裔美国人的“不值得的穷人”、种族偏见和医疗补助覆盖范围

《平价医疗法案》的医疗补助计划扩大了覆盖范围，尤其是对“不值得的穷人”——非残疾、非老年人、非裔美国人比例过高的成年人。然而，与其他群体相比，非裔美国人从医疗补助扩张中受益的程度要低得多，因为他们不成比例地居住在拒绝医疗补助扩张的州。心理学和其他社会科学研究表明，不赞成向“不值得的穷人”提供“福利”与种族偏见密切相关，并且这些情绪部分促使公众不赞成诸如针对非残疾、非老年人的医疗补助等政策。重要的是要澄清和承认这一障碍，以便从现实的角度看待保持和扩大医疗补助覆盖范围的障碍。