Medicaid Expansion Would Help More Latino Families Succeed

By Steven Lopez, Manager, Health Policy Project, NCLR
(cross-posted from the “Say Ahhh” blog of Georgetown University Health Policy Institute)


Steven Lopez of NCLR (left) joined CCF-NCLR Hispanic Children’s Coverage report co-authors at a press conference.

Latinos are the most uninsured population in the country. As the largest civil rights and advocacy organization in the nation, the NCLR works to improve the lives of Hispanic Americans, no matter who they are, where they live, or how much they or their families earn, and equitable access to health care is a top priority. Limited access to health insurance, among other factors, can contribute to worse health outcomes for Latinos. As a population, we are more likely than other racial and ethnic groups to experience chronic and largely preventable diseases. Being uninsured not only impacts physical and mental health it can undermine family financial security. The high uninsured rate experienced by Latinos makes them more vulnerable to economic instability and bankruptcy due to unpaid medical bills.

At this year’s annual NCLR convention in Kansas City, Mo., I led a workshop to address this pressing issue. The workshop, “Saving Lives and Strengthening Economies: Championing the Promise of Medicaid Expansion”, featured CCF Executive Director Joan Alker, Dr. Laura Guerra-Cardus of Children’s Defense Fund-Texas and Jared Nordlund of NCLR’s Department of Civic Engagement.

We discussed how the Affordable Care Act (ACA) has improved the lives of many Latinos by connecting them to affordable health care coverage and we outlined how we can make further progress. According to most accounts, more than four million Latinos have gained coverage since the ACA was implemented in 2010. While we’re certainly encouraged by this progress, this is no time to let up. All of us must keep working together to bring down the still-too-high uninsured rates for Latinos, who are now one in six Americans, one in four Americans under 18, and will represent nearly one-third of the U.S. workforce by 2050.

RNC_postpicsThe original design of the ACA required states to expand their Medicaid programs to serve individuals younger than 65 with incomes below 138 percent of the federal poverty level who meet certain qualifications. The Supreme Court’s 2012 ruling on the constitutionality of the ACA upheld Medicaid expansion, however, it limited the ability of the U.S. Department of Health and Human Services to enforce it. As a result, states have the option to reject the federal funding available for Medicaid expansion and deny affordable coverage intended for their residents by the ACA.

One consequence of the state-by-state expansion is that a large portion of the population is shut out of an opportunity to obtain affordable coverage because an individual earns too little to qualify for the economic supports to purchase a private plan through the Marketplace, yet too much to qualify for Medicaid under the state’s current eligibility requirements.

In Texas and Florida alone nearly one million Latinos are shut out of an opportunity for meaningful coverage because state leaders have refused to do what’s right for their most vulnerable residents and accept federal dollars to expand Medicaid.

HEALTH child getting ear checked_newsizeThese state decisions impact real people who fall into the coverage gap. It impacts individuals like Irma of San Antonio, 28 who is raising four children. She works as an assistant manager at a pizza chain earning $19,200 a year. She has damaged discs in her neck, making it difficult and painful to raise her arms, which in turn makes it hard to do her job. Sometimes her untreated high blood pressure makes her so dizzy she has to sit to keep from falling or fainting. She has no insurance and fears what would happen to her children if she fell ill. For Irma and others like her who fall in the coverage gap, Medicaid expansion would provide an opportunity to seek critical preventive services that could lower the risk of developing more complex conditions, which are more expensive to treat, later down the road.

Irma and others like her are the reason NCLR has long worked to increase quality, affordable and accessible health insurance care and we’ll continue that fight until everyone has the coverage they need to succeed. We know having access to the basic necessity of good health care improves the lives of people overall. It provides greater financial and social stability to families. It also markedly improves the educational prospects and chances for success later on in life for children. In short, health care is a critical building block to achieve a better life for individuals and families.

CHIPping Away at the Number of Uninsured Kids

By Steven Lopez, Senior Health Policy Analyst, NCLR


Last week, President Obama signed into law H.R.2, the Medicare Access and CHIP Reauthorization Act of 2015, bipartisan legislation that reauthorizes funding for the Children’s Health Insurance Program (CHIP), among other things. Since its creation in 1997, CHIP has played a critical role in reducing the number of uninsured children nationwide. According to a Government Accountability Office report, since CHIP began, the percentage of uninsured children has decreased by half, from 13.9 percent in 1997 to 6.6 percent in the first three months of 2014.The same report notes that when compared to uninsured children, CHIP enrollees had better access to care, including preventive care, and had comparable access to care when compared to children with private insurance.

NCLR has been a longstanding advocate of quality, affordable, and accessible health coverage for all and we recognize that by investing in programs like CHIP, we are making a critical investment in the future of the country. CHIP has been a particularly important lifeline for Hispanic children, who are more likely to be covered by the program than by private insurance. A recent evaluation of CHIP highlighted that in the 10 states examined, more than half of the children enrolled were Hispanic. But given today’s climate, just because a program is working doesn’t mean it will avoid being the centerpiece of a political showdown. Luckily, Congress decided that protecting our children’s health and well-being is something that we can all agree upon. And while we would have liked to have seen CHIP extended for four years instead of two, maintaining funding for a program that has been an essential coverage pathway for so many children, particularly Latino children, is certainly a win.

HEALTH-child-getting-ear-checked_1However, the work is not done. Now that we know the program’s funding is secure, we need to ensure those who are eligible are enrolled. Latino children continue to be disproportionately uninsured. In fact, they are 1.5 times more likely to be uninsured compared to all children. However, programs such as CHIP present an opportunity to further reduce this disparity. According to a report NCLR released last fall with Georgetown University, 66.1 percent of uninsured Hispanic children in the United States—or 1.3 million Hispanic children—were eligible for Medicaid or CHIP but not enrolled in 2012. Outreach to eligible families, particularly Latinos, is critical to increasing awareness of CHIP, its benefits, and the fact that unlike the ACA open enrollment period, enrollment in programs like CHIP and Medicaid occurs throughout the year.

We applaud Congress for exemplifying how to solve problems by working together and President Obama for acting swiftly to sign the bill into law. Now let’s make sure that every child not only has the opportunity for coverage, but is enrolled. To learn more about coverage opportunities in your state, go to or call 1-877-Kids-Now.

We Can Reach the Finish Line on Health Coverage for Hispanic Kids

By Sonya Schwartz, Research Fellow, Center for Children and Families, Georgetown Univeristy

(cross-posted from “Say Ahhh!” children’s health policy blog)

CCSS_boys_303x197Ensuring that every child in America has the protection of health care coverage is an attainable goal. In partnership with National Council of La Raza, this week we released a 50-state analysis of health coverage for Hispanic children. Our analysis found that Washington, DC is just a step away from the finish line already with 99 percent of Hispanic children covered, and other states have also made enormous strides.

The U.S. as a whole is also making steady progress, with the number of uninsured Hispanic children dropping by more than half a million from 2009 to 2013. However, despite this progress, two million Hispanic children continue to be uninsured, and Hispanic children are one and a half times more likely to be uninsured than all children. 

Which States Are In the Lead? About 80 percent of uninsured Hispanic children live in ten states—Texas, Florida, Arizona, Georgia, Nevada, Colorado, North Carolina, California, New York, and New Jersey. Three of these states —New York, California, and New Jersey—have brought their uninsured rate for Hispanic children below the national average.


What is the Special Sauce that Helps these States Succeed? There are a few ingredients that successful states have in common, and they all have to do with addressing barriers to coverage. Some of the key barriers include:

  • Fear: The vast majority (93 percent) of Hispanic children are citizens, but some live in families where their parents are not. Communicating to parents that it is safe to apply for health coverage for their children regardless of their own immigration status, and supporting trusted sources in encouraging them to do so, is a must.
  • Language: Limited English proficiency is a major barrier to coverage for parents trying to enroll their children in coverage and keep them enrolled. About one third (32.3 percent) of the U.S. Hispanic population over the age of five has limited English proficiency. With three fourths (73.3 percent) of this population speaking Spanish, it is important to create culturally appropriate health insurance outreach materials in Spanish in order to enroll eligible but uninsured children.
  • Paperwork: Getting through the application or renewal process for coverage can be daunting for all families, and is particularly hard for families applying for the first time or families that do not speak English well. The Affordable Care Act provided additional resources for enrollment assistance to more than 10 million people, yet not nearly enough resources to reach the bulk of the uninsured. Continuing to provide resources at all levels for enrollment assistance programs in trusted community environments makes a world of difference.
  • Coverage for parents as well as kids: Many of the the states that were most successful in improving Hispanic kids coverage not only provide affordable coverage for children, but also have had a commitment to providing affordable coverage for their parents. Research has shown that covering parents reduces the number of uninsured children.

Health coverage isn’t just about getting health care when you need it, it’s linked to school success, and improved financial security for families so we need to keep working to close this coverage gap. Strong Medicaid and CHIP programs have helped improve health coverage for a generation of America’s children.

This open enrollment period is a great opportunity to reach Hispanic families and encourage them to enroll for coverage along with their children. And we can encourage families to enroll their kids in Medicaid and CHIP all year long. Let’s build on this momentum and get all kids the coverage they need to succeed.