While everyone is waiting to see whether the Supreme Court will either uphold or repeal all or part of President Obama‘s landmark health care reform law, one thing is not in dispute. The current system is not serving Latinos well.
“One in three Americans who don’t have health insurance coverage are Latino,” says Jennifer Ng’andu, a health policy director at the National Council of La Raza (NCLR). Nine out of ten Latinos work in small businesses, Ng’andu explains, and most do not get health care coverage through their employer. The National Council of La Raza supports the new health care law, saying it will increase coverage for 6 million Hispanics.
Israel Ortega, editor of Libertad.org, part of the conservative Heritage Foundation, does not support the legislation. Like other Latino conservatives, however, he acknowledges the problem of lack of insurance among Hispanics. “Anyone who says it’s working right now is lying; people are falling through the cracks.”
Most Latino civil rights and health advocacy organizations do support the new health care law, and are hoping the Supreme Court upholds it.
“We believe that the Affordable Care Act is the most transformative legislation in our generation to provide the opportunity for quality health to the Hispanic community,” said Elena Ríos, a physician and president of the National Hispanic Medical Association (NHMA). The NHMA was one of several groups which filed a friend of the court brief to the Supreme Court supporting the legislation.
“It is already changing lives,” says NCLR’s Ng’andu. She touts some of the provisions already put in place, such as allowing almost one million Latinos under 26 to stay in their parents health insurance plan if they do not have their own, or prohibiting insurance companies from denying coverage to children with pre-existing conditions such as asthma or diabetes. It also involves the biggest expansion of Medicaid for Latino adults – the new law would provide Medicaid insurance for families whose income is less than 133 percent of poverty, which is about $29,000 for a family of four.
Under the new law, individuals are required to get health insurance – either through their employer, through a health care exchange or through the open market. Employers with more than 50 employees have to either provide health insurance coverage or pay a penalty, and companies with less than 50 employees can utilize the health care exchanges.
The big issue before the Supreme Court is whether it is legal for Congress, under the “commerce clause,” to make all Americans buy health insurance. The administration argues the only way to fund the system is to make sure healthy Americans buy insurance, not just when they are sick. Dr. Elena Ríos of the National Hispanic Medical Association, agrees, saying requiring most Americans to buy insurance helps ensure that costs are not shifted to others or the government.
Though a few conservatives and Republican legislators had originally supported the concept of a mandate in the 1990s, current conservative voices vigorously disagree.
“I absolutely believe it is unconstitutional to make someone purchase insurance,” says Libertad.org’s Ortega. Republican Senator Marco Rubio says the law places too much of a burden on individuals and employers, and “will drive costs up, bankrupt the country and create bureaucratic red tape.” Several states, including Florida, sued over the requirement to expand Medicaid, saying it is too much of a financial burden.
Dr. Richard Seidman is the chief Medical officer at the Northeast Valley Health Corporation, which serves over 65,000 mainly Latino patients. He disagrees with conservatives that the private market can solve the issue of so many uninsured.
“Most of the working Latino adults I see do not have access to insurance,” Dr. Seidman says. “If there was a market solution to the nation’s 50 million uninsured, how come it has not been resolved already?” As part of the health care law’s preventive care expansion, community health centers such as Northeast Valley’s have seen an increase in funding.
“Some community centers are currently being built to expand coverage,” says National Council of La Raza’s Ng’andu. “If the law is repealed, what are we going to do, tear the buildings down?” she asks.
Regardless of the Supreme Court decision, most Latino activists say the law has already made a difference.
“In my district – 20,000 children and 80,000 adults now have health insurance that covers preventive services,” said California Democratic Congresswoman Loretta Sánchez.
“Over 18 percent more Latinos are expected to be covered under the new law, more than any other group in the country,” says NCLR’s Ng’andu.
“If the law is upheld, we will work to make sure it is fully implemented, and if it is repealed, we will hold our legislators accountable,” she adds. “You just can’t pull the rug from underneath Americans.”