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Monday, October 3, 2016

Victories and Hispanic Heritage Month: September Health Equity Update

Emmett Ruff

Health Equity Intern

Several important health equity victories coincided with Hispanic Heritage Month.

We got news that the Latino uninsured rate is lower than ever, there is more progress in immigrant access to health care in California and Illinois, and the federal government saved Ohio’s Medicaid program from harsh restrictions that would have cut access to health care for tens of thousands of people.

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Historic gains in Latino coverage and access to care—yet gap remains

Latinos, as the largest racial or ethnic minority group in the nation, have been historically much more likely to lack health insurance than any other group.  While that continues to be true, in early September, the U.S. Census reported some encouraging progress: Last year, Hispanics experienced the biggest drop in the uninsured rate of all ethnic groups—down to 16.2 percent in 2015. 

This is the lowest uninsured rate ever recorded for Hispanics. 

Moreover, this increase in access to insurance has resulted in concrete improvements in access to health care—including among Latina women.  

As we recently described, more Latinas are reporting having a regular source of health care and fewer than ever say that cost is a barrier to getting care. 

Despite these impressive gains, there is still much work to do to eliminate inequities in Latino health coverage. As noted in a new Commonwealth Fund report, multiple factors contribute to Latinos having the highest uninsured rate, including:
•    Being more likely to work in jobs that don’t offer insurance 
•    Legal restrictions based on immigration status
•    Being least likely to know about the health insurance marketplace and the financial assistance available to help pay for the cost of coverage 

With open enrollment around the corner, advocates and community leaders have an opportunity to build on this progress and ensure that even more Hispanics get covered!  

Federal government protects 125,000 Ohioans from losing Medicaid

The United States currently has the lowest uninsured rate in history, thanks in part to increased access to Medicaid in the 32 states including the District of Columbia that expanded it under the Affordable Care Act.

Unfortunately, some state governments are trying to roll back this progress by placing new rules and restrictions on people enrolled in Medicaid through a Section 1115 waiver. Such restrictions would result in many people being denied access to the lifesaving program.  

In September, the Centers for Medicaid and Medicare Services (CMS) rejected Ohio lawmakers’ attempt to erect new barriers to coverage. CMS’s decision preserves the existing Medicaid expansion and protects approximately 125,000 Ohioans from losing their access to health care. 

Ohio’s waiver proposed charging all Medicaid enrollees monthly premiums, kicking them off the plan if they couldn’t pay, and locking them out (denying health coverage) until they did. This policy would have had a disproportionate effect on Ohio’s minority communities: Even though the majority of people covered by Medicaid in the state are white, Ohio’s communities of color are more likely to need Medicaid to get health care.

Momentum building to provide health care access for immigrants

Over the last several weeks, advocates for health care access for immigrants have celebrated two important milestones.  

Chicago: First, a coalition of advocates based in Chicago, Illinois, led by Healthy Communities Cook County-–a coalition co-convened by Communities United and the Illinois Coalition for Immigrant and Refugee Rights—persuaded the Cook County Board to establish a program to provide health care services to lower-income people who are barred from Medicaid. 

An estimated 180,000 people in Cook County are unable to obtain health insurance, many due to their immigration status. While this program is not insurance, it meets a critical need for a community with no realistic coverage alternatives and is expected to improve health outcomes and reduce emergency room visits for this vulnerable population.

People with incomes up to 200 percent of the federal poverty level will be able to enroll in this coordinated direct access program run by the Cook County Health and Hospital System. The program will provide much-needed primary care and specialty services at little to no cost. 

California: Meanwhile, California moved one step closer to allowing undocumented adults to buy health insurance on the marketplace. Earlier this month, advocates and state officials traveled to our nation’s capital to persuade the Obama administration to approve the state’s section 1332 innovation waiver. 

The waiver, which was passed by the state legislature and approved by Governor Jerry Brown in June, would allow undocumented immigrants to purchase health insurance on the state’s marketplace. It is estimated that 17,000 people would be newly eligible in 2017. 37 members of California’s congressional delegation have signed on to a letter urging the Secretaries of the Treasury and Health and Human Services to approve the waiver.  

California approves new Asian American and Pacific Islander data disaggregation law

Earlier this week, California Governor Jerry Brown signed into law a bill that will break down (or "disaggregate") state public health data related to Asian Americans and Pacific Islanders (AAPI). Under the AHEAD Act (AB1726), which was introduced by California Assemblyman Rob Bonta, California’s health department will include at least 10 new ethnic subcategories when collecting public health data. 

A coalition of AAPI advocates, including APIAHF, SEARAC, EPIC, and CPEHN worked to get this law passed. The law will enable researchers, policymakers and advocates to better identify, track, and address the health disparities that affect specific ethnic subgroups within the much broader AAPI population. 

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