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Wednesday, March 23, 2016

New Enrollment Data: March Health Equity Update

Welcome to the new Health Equity Highlights monthly blog! Our Health Equity Connection newsletter has been promoted: Every month, you will now be able to find the latest health equity updates, top resources from Families USA and our partners, and important upcoming events here.  

Read on to learn about new marketplace enrollment data, progress in covering immigrant children, upcoming health equity events, and more.

Increases in enrollment in Affordable Care Act marketplaces drive historic reductions in number of uninsured people of color

Earlier this month, the U.S. Department of Health and Human Services (HHS) released new data showing that, since enactment of the Affordable Care Act (ACA), 20 million adults have gained health insurance. This means that more than 90 percent of Americans now have health coverage.

Progress for communities of color has been significant, with the rate of uninsured African Americans declining by almost 53 percent and the Hispanic rate declining by 27 percent compared to 2012. Though there is progress, coverage disparities persist: The overall uninsured rate for African Americans is 10.6 percent and 30.5 percent for Hispanics, compared to just 7 percent for whites.

These reductions in the uninsured rates in communities of color have been driven by enrollment in the ACA marketplaces. HHS recently reported that, across the 50 states, 12.7 million people enrolled in marketplace coverage for 2016. Coverage gains among most communities of color through the federal marketplaces appeared particularly strong.

While the reported data are not complete, because roughly one-third of federal marketplace enrollees did not indicate their race and ethnicity, we know that at least 915,000 self-identified Latinos signed up for health insurance through the federal marketplaces for 2016 coverage—a 50 percent increase over those who signed up for 2015 coverage. Compare this increase to enrollment through the federal marketplaces for self-identified whites, which increased by less than 5 percent.

Another group with a huge jump in enrollment was Native Hawaiian and Pacific Islanders, with a nearly 40 percent increase in sign-ups. Additionally, at least 705,000 African Americans, 530,000 Asians, 29,000 American Indians/Alaska Natives, and 82,000 mixed race people enrolled in 2016 coverage through the federal marketplace.

This progress in insuring communities of color—a foundational step in reducing health disparities—is a testament to the tireless work of enrollment assisters, community organizations, and advocates across the country.

New documentation standards required for special enrollment periods could pose barriers for some communities

Last month, the Centers for Medicare and Medicaid Services (CMS) announced new documentation standards for special enrollment periods (SEPs). SEPs are an important avenue for consumers with major life changes—losing a job, getting married, moving out of state, or having a child, among others—to enroll in health insurance. These new rules will require people to provide specific documents to prove that they have, in fact, experienced a qualifying life event.

While these may seem like reasonable requirements, for some consumers, they may be very difficult-to-nearly impossible standards to meet. The new rules may increase confusion about the enrollment process and discourage eligible people from getting covered. Families USA has submitted comments to CMS that outline our concerns about these changes. The government should be making it easier—not harder—for people to enroll in health coverage.

Efforts continue to make health insurance accessible to more immigrants

Across the country, momentum is building to ensure that everyone has health insurance, regardless of immigration or citizenship status. Building on last year’s historic accomplishment in California, which saw Medi-Cal (the state’s Medicaid program) extended to undocumented children, California advocates continue to work through the Health4All campaign to extend Medi-Cal to low-income undocumented adults.

Florida advocates celebrated a big win last week when Governor Scott signed a Medicaid budget that includes a provision providing coverage to documented immigrant children of legal immigrants who are excluded from Florida Kidcare (Florida’s Medicaid program for children) because they fall in the five-year waiting period known as the five-year bar. Starting July 1, an estimated 17,000 kids will become eligible for coverage under this program.

New Yorkers have also taken on this goal. A coalition of 170 organizations called Health Care for All New York recently launched its ‘Coverage 4 All’ campaign. This coalition, which includes groups like New York Lawyers for the Public Interest, New York Immigration Coalition, and Make the Road New York, seeks to allow undocumented immigrants to have access to New York’s Essential Plan—the state’s most basic health insurance option. This would give more than 100,000 people access to much-needed health coverage.

Finally, Oregon recently saw a huge breakthrough when the legislature unanimously passed a health care program that will give 1,500 low-income adult migrants access to Medicaid-like insurance. These migrant (who are formally called Compact of Free Association migrants) are Oregonians who are legally-residing Pacific Islanders from the former U.S. territories of Guam and the Northern Marianas.

The Feds expand Medicaid for residents of Flint, Michigan, to help address health effects of toxic tap water

This month, the U.S. Department of Health and Human Services (HHS) expanded Medicaid and services in Flint, Michigan, in response to the lead contamination crisis. Approximately 15,000 additional children (up to age 21) and pregnant women will be eligible for Medicaid, and an additional 30,000 current beneficiaries will receive expanded services to help treat the array of health problems caused by the toxic water supply. 

Top Health Equity Reads and Resources

Spotlight: National health equity leader and long-time friend of Families USA, Daniel E. Dawes, published an important new book this month called 150 Years of Obamacare. It provides a comprehensive history of how the health reform movement and the health equity movement evolved over the decades and offers a behind-the-scenes look at how it all came together in the effort to create and enact the Affordable Care Act. (Lisen to an audio preview)

Creating the Business Case for Achieving Health Equity, Dr. Marshall Chin, RWJF Reducing Health Care Disparities through Payment and Delivery System Reform Program.

Medicaid Suspension Policies for Incarcerated People: 50 State Map, Elizabeth Hagan, Families USA.

Getting Enrollment Right for Immigrant Families, Georgetown Center for Children and Families.

Diabetes in the U.S.: Trends in Rates, Outcomes, Spending, Peterson-Kaiser Health System Tracker.

A Look at Data for Medicare Beneficiaries by Race and Ethnicity, Kaiser Family Foundation.

Medicaid and American Indians and Alaska Natives, Samantha Artiga & Anthony Damico, Kaiser Family Foundation.

Hospitals Participating in Accountable Care Organizations Tend to Be Large and Urban, Allowing Access to Capital and Data, C. H. Colla, V. Lewis, E. Tierney et al, Commonwealth Fund.

Upcoming Health Equity Events