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.

We’re Committed to Protecting Health Care

The Affordable Care Act (ACA) has the potential to significantly reduce the number of uninsured Latinos in the United States, and NCLR has worked to ensure that the benefits of the law reach as many eligible individuals as possible. As an organization that represents the most uninsured community in the country, NCLR has long advocated for quality, affordable, and accessible health insurance and care for all Americans. It is why we became deeply involved in the fight to enact the Affordable Care Act. While it is not perfect, it is the first meaningful effort in nearly 50 years to address the long-standing national health care gap and at long last bring quality health care to millions of families in the U.S., including Latinos.

Alejandra Gepp, Director of the NCLR Institute of Hispanic Health, and Steven Lopez, Senior Health Policy Analyst outside the Supreme Court this Wedensday.

Alejandra Gepp, Director of the NCLR Institute of Hispanic Health, and Steven Lopez, Senior Health Policy Analyst outside the Supreme Court this Wedensday.

Earlier this week, we continued that fight when we joined numerous organizations on the steps of the Supreme Court to affirm our support for the ACA as the Court heard oral arguments in King v. Burwell. The case challenges a core component of the ACA, endangering the financial assistance that the law provides for millions of low- and middle-income Americans who live in states that did not set up their own health insurance marketplaces.

The outcome of King v. Burwell is critical. According to a widely referenced report by the Urban Institute and the Robert Wood Johnson Foundation, about 9.3 million people in 34 federally facilitated marketplace states are at risk of losing premium tax credits if the Court rules in favor of King. About 8.2 million people are projected to become uninsured. Such a decision by the Supreme Court would be a step backward for all Americans, including Latinos, stripping away the gains we have made in providing quality, affordable coverage to so many hardworking families.

What does this mean for Latinos?

Outside the Supreme Court, NCLR talked with a number of news outlets. One key question we fielded was, “What’s at stake for the Latino community?” According to a follow-up report by the Urban Institute, of the 9.3 million people who would lose tax credits if the Court ruled in favor of King, about 1.5 million are Hispanic and about 1.2 million would become uninsured as a result.

ACA_SCOTUS1Given that Latinos are less likely than other workers to have access to employer-sponsored health insurance—only 38.3 percent of Latinos are covered by employer-based plans—the coverage options offered by the ACA are critical to filling that gap. During the first two open enrollment periods, NCLR and its Affiliate Network, along with other key partners, worked to enroll Latinos across the country. There is still work to be done, but there is no question that these collective efforts have increased the number of insured Latinos.

While the country awaits the Supreme Court’s decision in June, remember that nothing has changed. Tax credits remain intact and coverage purchased via the marketplace remains valid. It’s important for individuals to continue paying their premiums. As a community that has long strived for meaningful coverage opportunities, Latinos, like so many Americans, have much to gain from the ACA. Our community can ill afford—literally and figuratively—attempts to thwart those opportunities.

Effective Outreach is Crucial for Getting Latinos Covered


NCLR held a briefing today to address the opportunities and challenges that Latinos face nationwide in enrolling in or renewing health insurance under the Affordable Care Act (ACA). Our experts reported that bilingual materials, the availability of knowledgeable navigators and extensive community outreach to answer questions about deadlines, eligibility and financial help would improve Latino participation. The second ACA open enrollment begins Nov. 15, 2014 and ends Feb. 15, 2015. Information and enrollment applications are available at and or by calling 1-800-318-2596.

Below are highlights from the event:

NCLR’s Senior Vice President for Programs, Delia Pompa, delivered opening remarks.

Panelists for the press briefing included:  Sinsi Hernández-Cansio, Director of Health Equity, Families USA, Steven Lopez, Manager, Health Policy Project, and NCLR, Mayra Alvarez, CMS, U.S. Department of Health and Human Services.


The report is also available below:

Hispanic Childrens Coverage