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Friday, May 13, 2011

Latin Americans: A disproportionate share of the uninsured

Veronica Guerra, MPA

Healthcare in America is designed as a multi-payer or privatized system, meaning everyone is responsible for securing his or her own health services. Excluding the young and old who are covered under federal or state social welfare programs, the majority of Americans get healthcare either through private insurance or their employer. Yet, nearly 55.6 million Americans lack access to basic health services, and even those who do find costs prohibitive: nearly half of bankruptcies in America are related to medical care payments. These statistics become paradoxical when one considers ballooning national expenditures in the health services industry.

In 2005 almost 34% of Latinos were uninsured, constituting a disproportionate share of the nation’s uninsured population. (This high rate has also led to further exacerbation of existing health inequities and to more pronounced health disparities.) The likelihood of being uninsured is far higher among non-citizen Latinos who primarily speak Spanish. There are various factors that contribute to the increasingly uninsured status of the Latino population, including employment, employee benefits, household income, language, and citizenship status.

Immigration from Latin America to the United States has steadily risen over time. Latino citizens and non-citizens are less likely to have both public and private insurance coverage. Non-citizens do not qualify for various public programs including Medicaid and the State Children’s Health Insurance Program (SCHIP), and legal immigrants often do not apply for public programs because of fear of jeopardizing their residency status or because they are ineligible during the first five years of gaining residency. When employed, they are less likely to receive employee health benefits, and low-wages prevent the purchase of private insurance. In general, minorities and immigrant families have lower average incomes than white citizen families. These income differences pose a challenge in obtaining health benefits because low incomes lead many families to make difficult decisions between health care coverage and other basic necessities due to the increasing costs of health coverage.

Language also has an implicit effect on uninsured status. Those who have limited English proficiency may have limited employment opportunities and may work in low-wage sectors that do not offer employee health benefits. Furthermore, language barriers both pose a challenge in completing insurance applications and may compromise the quality of health care when access is obtained.

One important recommendation that could decrease the number of uninsured is to restore public insurance eligibility for legal immigrants, either through federal legislation or at the state level through programs such as Medicaid and SCHIP. Resources should be concentrated in the Latino community to help reduce the number of uninsured and decrease medical expenses incurred through emergency care visits. Existing resources that provide care for the uninsured such as safety-net clinics should be improved and provided increased funding to meet the high demand for their services. Additionally, policies that improve the quality of jobs held by Latinos or that incentivize businesses to offer insurance to low-income workers could lead to increased offers in employer-based health insurance. Processes to apply for insurance—whether public or private—should be streamlined and accessible to those who require language assistance. It is important that government efforts be focused on decreasing health disparities, improving preventive efforts, and increasing access to health care coverage for adults and children. This is not simply beneficial to the Latino community, but to Americans nationwide.

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