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