As payers look to increase health equity and outcomes among their members, some are improving or developing strategies to collect better data surrounding race and ethnicity.
In 2019, fewer than 25 percent of commercial health plans had race data for even half their members.
Health plans are using racial and ethnic data in two major areas, according to the National Institutes for Health: to address preventive care issues within specific populations and to identify populations at higher risk for certain chronic conditions.
Collection and reporting of data on race and ethnicity is federally legal under Title VI of the Civil Rights Act of 1964, but payers can find legal barriers at the state level.
This month, Pennsylvania ended a 1969 ban on payers collecting race and ethnicity data, citing the need for the data to promote health equity.
Five states currently have laws or regulations preventing or restricting payers from collecting data on race and ethnicity on insurance applications:
California: The state has a provision in its insurance code that bans payers from identifying an applicant's race, color, religion, ancestry, national origin or sexual orientation on an insurance application.
Maryland: The state's insurance code states that payers cannot ask about race, creed, color or national origin on any insurance application or related forms, unless "the information is used solely for the evaluation of quality of care outcomes and performance measurements."
New Jersey: The state's administrative code states, "Application forms shall not include provisions, statements or questions that: pertain to race, creed, color, national origin or ancestry of the proposed insured, except for hospital-medical insurance application forms for the purpose of collecting demographic data."
New Hampshire: The state's administrative rules say "questions as to race or ethnicity shall be prohibited" in regard to "all application forms used in connection with the offer and acceptance of insurance."
New York: The state's official code states "No application shall contain questions as to race of the applicant" in regards to insurance.
The above five states only prohibit race and ethnicity data collection on applications for insurance, and not once an individual is a member, according to AHIP. Furthermore, the restrictions only apply to state-regulated plans. They would also not apply to self-insured and insured ERISA-governed employer-sponsored health plans.