The United States is considered the land of opportunity, yet our fragmented health coverage system leaves one in seven Americans without health insurance and prevents many individuals and families from taking full advantage of all the opportunities our country has to offer. Lack of health care access and coverage has negative repercussions on all facets of life and this is a particular problem for people of Hispanic origin, who comprise the nation’s largest racial or ethnic minority group and are the most likely to lack health insurance coverage.
Nearly 33% of the 40 million Latinos living in the United States are uninsured. Last month, Census data showed that 800,000 more individuals lacked health insurance in 2004 than in 2003. Stunningly, more than half of those individuals are Hispanic= While language barriers may partially explain this phenomenon, lack of coverage significantly contributes to Latinos’ limited access to care. Like other uninsured families, a Latino family is more likely to rely on a hospital emergency room as their usual source of care compared to a family with coverage. Also, a Latino family is more likely to put off needed medical care, such as medications for asthma or mental illness, due to cost, thus exacerbating existing health conditions.
With these problems accessing health care, it is little wonder that Latinos live sicker and die younger than other groups. Latinos can expect to live a shorter life than their non-Hispanic, white counterparts. Roughly half of the child Latino population is obese and at an increased risk for diabetes. More than 80% of the pediatric aids cases are of Latino or African-American children. Although Latinos are less likely than whites to develop most cancers, they are at a higher risk for stomach and liver cancer. Additionally, manageable, chronic conditions – particularly diabetes and heart disease – are leading causes of death for this population.
But why are Latinos uninsured? Some analyses suggest that the majority of Latinos lacking health coverage are unemployed. However, this is a misconception. Over 35% of working Hispanic adults are uninsured, which is two times the rate for black working adults, and three times the rate of white working adults.
Other analyses are more on target. They suggest that Latinos lack coverage due to the type of jobs they hold. A disproportionate number of Latinos work in the service sector as maids and cooks, cleaners and care-givers, as well as painters and other construction-related positions. These jobs frequently are part-time and low-paid, and do not offer health insurance. If health coverage is offered, the low-wages earned are not enough to pay their portion of cost sharing. These individuals and families find themselves unable to meet their most basic health care needs – regular check-ups, routine immunizations, and necessary medications become luxuries they cannot afford.
But Latinos not only lack coverage because of barriers to employer-sponsored-insurance, they have limited access to public health insurance as well. Legislative changes in 1996 delayed Medicaid eligibility for many legal immigrants and punctured holes in the health care safety-net that traditionally treated legal immigrants and citizens equally. For example, Washington moved immigrants from look-alike coverage to a program with limited benefits and premium and cost sharing requirements, which have led to significant coverage losses among immigrants. Additionally, states are not allowed to provide immediate Medicaid coverage to two of our most vulnerable populations, children and pregnant women who have recently immigrated to this country. And to compound the problem, undocumented immigrants, many of whom are of Latin American descent, are ineligible for Medicaid, with the exception of emergency medical services that are covered by Medicaid.
With this lack of access to and coverage for health care services, it is little wonder that health care spending for Latinos is low. The average cost on all health care services—including services covered by health insurance, out-of-pocket costs, and uncompensated care—for native-born Latinos was $1,870 per person and for foreign-born Latinos is $962 per person at the end of the 1990s. Health spending for native-born whites and white immigrants were three and two times those amounts respectively.
The lack of access, and therefore the lack of opportunity caused by the fractured health care system, can be remedied. The Center for American Progress has developed a plan to provide coverage to all, establishing new options for individuals and businesses to purchase coverage through group arrangements – giving all employees, regardless of job sector, opportunity to health care in the private market. Also, the plan proposes to expand Medicaid to not only cover the neediest people in the country, but to ensure that the working-poor have access to health care as well.
As we recognize and celebrate the contributions of Hispanic Americans this month, our efforts should focus beyond celebratory gatherings and festive music to ensuring that Latinos in this country have access to health care and health care coverage. Like other issues of importance to the members of the Latino community, expanding health care access and coverage merits much more debate and consideration than can occur in a single month. This is an issue that should demand our attention everyday of the year, just as it affects the lives and well-being of Latinos everyday. Hard-working Latino families in the US deserve nothing less.
Meredith L. King is the health policy research analyst at the Center for American Progress.