With the new health insurance marketplaces open for enrollment, millions of Latinos will gain substantially from the milestone Patient Protection and Affordable Care Act, also known as Obamacare.
A third of Latinos lack health coverage, and 1 in 3 lives below the poverty level, according to the Kaiser Family Foundation, a health policy nonprofit. But beginning this month, about 10 million Latinos in the U.S. will gain access to affordable health insurance through the expansion of Medicaid and the new marketplaces, also known as exchanges.
The expansion should be smooth in places like California, Colorado and Florida, which are among the states with the highest concentration of Latinos. But Affordable Care Act education and enrollment for Latinos may be an issue in other areas, says Arturo Vargas Bustamante, assistant professor at University of California Los Angeles' Department of Health Policy and Management.
"Many Latinos have been moving to states that have not experienced (much) Latino immigration -- North Carolina, North Dakota, Alaska," he says. "These are places that are not necessarily familiar with providing information in Spanish.”
Despite the roadblocks facing certain Latinos, here are four major ways Obamacare will impact the nation's largest ethnic group.
1. Access to low-cost health insurance
"One of the reasons (Latinos are) uninsured is that they're the least likely to be offered any insurance options through the workplace," says Jennifer Ng'andu, director of the Health and Civil Rights Policy Project at the National Council of La Raza, a civil rights and advocacy organization for Hispanics. Many Latinos work in the service, construction and maintenance industries, which often offer low-paying jobs, according to her organization's research.
Obamacare will require employers with 50 or more full-time workers to offer health care coverage starting in 2015. However, some companies may opt out of offering coverage and will have to pay a penalty – between $2000 and $3000 per employee. Employees who work at these companies may purchase coverage through the exchanges.
Individuals who make up to 400 percent of the poverty level, or about $46,000 annually, can qualify for a subsidy when they use the exchanges. And there's a third option for people who have very low income: Medicaid, which is expanding in many states under Obamacare, will be available to an estimated 6.4 million more Latinos under the expansion.
2. Access to preventive medicine and screenings
Latinos as a group consistently skip preventive care measures, says Josephine Mercado, director of the Florida-based group Hispanic Health Initiatives. The reason for this, Mercado says, is that many Latinos lack the health education to recognize the warning signs of an oncoming chronic disease.
All health plans sold on the exchanges must cover 10 essential benefits, including free preventive care. Preventive care is necessary for the Latino population because:
- Hispanic women are 1.6 times more likely to contract cervical cancer than white women and are likely to be diagnosed with breast cancer at a late stage, primarily due to a lack of cancer screening, according to the National Cancer Institute. The preventive measures include certain cancer screenings, access to contraception and more.
- About half the Latino population is younger than 26, and a new Obamacare provision allows youths to remain on their parents' health insurance until that age. Obamacare health plans will also cover vaccinations and screening for developmental conditions.
- Nearly 32 percent of Latinos were obese in 2010, but health plans now cover services for adults including Type 2 diabetes testing, nutrition counseling, blood pressure screening and more.
3. Spanish-language resources
Of the 10 million Latinos who will have access to health coverage, about 4 million of them use Spanish as their primary language. For some, this can lead to problems, Ng'andu says.
"Latinos often cite the inability to effectively communicate with the doctor," she says, adding that research consistently shows a lack of adequate patient-doctor communication between Latinos and non-Spanish-speaking health care professionals.
Here are a few new tools that could help bridge the language divide.
- CuidadoDeSalud.gov, the sister site to HealthCare.gov, aims to provide resources, education and marketplace enrollment tools in Spanish.
- Exchanges must create uniform explanation of benefits (EOB) documents, coverage summaries and appeals process information that are culturally and linguistically appropriate.
- Federal funding is available to employ and train navigators to enroll people and spread information, and many health centers are working to hire Spanish-speaking navigators. "Promotoras" don't go through the same certification process as navigators, but do help educate Latinos on the new law and healthy living.
4. Outreach programs and funding
Experts like Antonia Villarruel, associate dean for research and global affairs at the University of Michigan School of Nursing, think more can be done to improve education about the new law. The fact that the government's Spanish-language website for health insurance enrollment, CuidadoDeSalud.gov, is not up and running is "telling," she says. Some estimates say it won't be ready until Oct. 21 2013.
Villarruel says: "Ten million (Latinos) aren't going to be enrolled without some concerted effort by everyone."
Here are some ways the government and grassroots organizations are expected to promote ACA education, programs and services:
- The U.S. territories will receive $6.3 billion in Medicaid funding, and Puerto Rico can create an exchange and receive $925 million to subsidize low-income people who participate in the exchange.
- The legislation provides grants for training health care providers in "culturally competent" care and services.
- The National Institute on Minority Health and Health Disparities will research health disparities among minorities living in the U.S. - such as Latinos – and come up with solutions and funding to address the disparities.
- Organizations such as Hispanic Health Initiatives will ensure that educational information on the law is available in Spanish and English, as well as encouraging more Latinos to enroll.
"What we've found is that you really have to harness the power of community-based organizations," Ng'andu says, "and you have to trust the community to get the word out and combine that with more broad communication."