It is crucial to confront the problem of health inequity that Black women are experiencing. Black women have a higher risk of pregnancy-related complications and experience worse outcomes in cardiovascular diseases, diabetes, high blood pressure, and mental health. Even with the Affordable Care Act, Black women still may not have access to affordable health insurance. This study examines the impact of race on healthcare coverage for women in Louisiana, which expanded Medicaid, and Mississippi, which did not. The study uses a quasi-experimental analysis to compare insurance coverage across states using publicly available data from the 2010 and 2021 American Community Survey. A chi-squared test determined a significant correlation between race and insurance type in both states. Insurance coverage for Black women increased in Louisiana. Women in Mississippi made slight gains even without Medicaid expansion. Despite these gains, racial disparity among women persists. Policymakers should strive for affordable healthcare for all women, regardless of race and geography.