Fact Sheet on Healthcare and its Impact on the Latino Community | LULAC-League of United Latin American Citizens

Fact Sheet on Healthcare and its Impact on the Latino Community.

Background: Healthcare Reform in the United States.

Healthcare is one of the most critical and challenging issues at this stage of U.S. history. It has even been suggested that healthcare reform in the United States is “possibly the most complex legislation in modern history” (www.nytimes.com/2009/07/28/us/politics/28baucus.html). There are a variety of issues associated with the healthcare debate. Forty-six million Americans are uninsured and 25 million are underinsured (www.cnn.com/2009/HEALTH/06/18/ep.health.reform.basics/).

Healthcare insurance prices are steadily on the rise as are health problems. Expenses on healthcare are expensive, compared to the costs that citizens from other nations pay on average. Americans pay on average $6,714 annually; citizens of the United Kingdom pay on average $2,760; French citizens pay $3,449. Many criticize that these high costs suggest neither increased investment in the healthcare system nor do they guarantee an overall healthy citizenry. The CIA Factbook reports that the U.S. ranks 50th in life expectancy and 180th in infant mortality, placing 43 spots away from the country with the lowest infant mortality rate. Besides overpriced healthcare coverage, Americans are also growing more skeptical of pharmaceutical companies.

The cost of medications has been an ongoing problem in the United States, making affordable medication another top priority (www.ismp.org/newsletters/acutecare/articles/20040520.asp). The outbreak of the H1N1 flu reconfirmed the urgency of the healthcare dilemma. Since its outbreak in April 2009, the H1N1 flu has had 43,771 cases and claimed 302 lives in the United States, as of July 24, 2009 (www.cdc.gov/h1n1flu/update.htm).The Obama Administration, and both Democrats and Republicans of the Senate and the House of Representatives have proposed various solutions to the current healthcare crisis.

In addition to these bills, several proposals have been made by public officials, individuals, and corporations on how Americans can proceed in this healthcare debate. For instance, in December of 2008, Governor Patterson of New York State proposed an “obesity tax” – a 15% tax on non-diet sugary soft drinks (www.foxnews.com/story/0,2933,468245,00.html). Patterson projected that the revenue from the “obesity tax” would be approximately $404 million dollars per year. This “obesity tax” has been criticized by those who believe that it is a government attack on lifestyle choices and culture. It is supported by those who believe that soft drinks are unhealthy and taxing them would hypothetically deter consumption and, in turn, obesity.

The supporters of this tax believe that lowering obesity will in turn drop healthcare and medication expenses to treat obesity and other diseases linked to unhealthy eating habits. Many doubt that this tax would be effective; one health care scholar regarded the proposal as “social engineering” (money.cnn.com/2009/07/28/news/economy/health_care_reform_obesity/index.htm). In July 2009, the Urban Institute published a study entitled, “Reducing Obesity: Policy Strategies from the Tobacco Wars,” which discusses convergences between the government’s tactics used in versions of an “obesity tax” and the tax on tobacco products (www.urban.org/UploadedPDF/411926_reducing_obesity.pdf).

There have been several precedents made to the current healthcare reform movement. The first major healthcare reform era began in the early twentieth century, led by reformers of the Progressive Era, such as the Socialist Party, which supported a compulsory healthcare system in 1904. Additionally, President Theodore Roosevelt’s Progressive Party’s platform included health insurance. In the past, labor unions such as the American Federation of Labor (AFL) and the American Association for Labor Legislation (AALL) have been involved in reform in the healthcare system. Under the Truman Administration in the 1940s, the Wagner-Murray-Dingell bill proposed a national medical insurance program, which would have been financed by social security payroll taxes. Fear of “socialized medicine” during the Cold War era contributed to the failure of the bill’s passage. In 1945, President Truman asked Congress to pass legislation on a national healthcare plan. Twenty years later, in 1965, President Johnson signed Medicare into law, as a part of the Social Security Act.

More recently, in 1993, the Clinton Administration made healthcare reform a top agenda national issue. Clinton introduced the State Children’s Health Insurance Plan (SCHIP), which was established to provide medical coverage to children of families who earned an income too high to qualify for Medicaid (www.urban.org/health_policy/medicaid/medicaid-and-schip.cfm). The Clinton healthcare reform effort, named Hillary Care, was summarized in a 1,000-paged document. The ultimate failure of this effort was attributed to Republican speculation that the proposed healthcare system would give the government too much power (www.cnn.com/2009/POLITICS/07/22/obama.clinton.health.care/index.html).

Many Republicans assert that the current administration is also exerting too much government power and bureaucracy, rather than leaving people to make their own decisions about their healthcare and insurance. Some criticize that Obama’s current healthcare reform movement will altogether reflect the last major reform movement led by the Clinton Administration and eventually fail.

House Democrats have composed the most widely-discussed healthcare reform proposal. Republicans have accused House Democrats of creating a document that permits the government to have too much control. Some Republicans have stirred a virtual panic over the House Democrat proposal, sending messages through radio waves and television commercials that make outlandish statements such as “Obama wants to kill your grandma.” In addition to these statements, they have bent the truth in claiming that the government will refuse some Americans of healthcare in order to pay for abortions for others. It is true that this bill does not mention abortions, but this does not necessarily mean that the new healthcare system will provide abortions. Some Republicans have claimed that Obama plans to forbid private insurance. Obama has denied this claim – none of the reform proposals, in fact, forbid private healthcare or will deny those who wish to continue with their current providers.

Others have asserted that the government will be inefficient in the managing of the healthcare system, comparing it to the ineffectiveness of other government agencies, such as state-run Departments of Motor Vehicles. Both Republicans and Democrats, armed with television and radio ads against other partisan and the Obama healthcare reform plans, have propelled the outbreak of mobs publicly expressing their opposition to certain healthcare reform plans, oftentimes in violence. These mobs have recently grown so overwhelmingly uncontrollable that they have already led to several hospitalizations and arrests (www.nytimes.com/2009/08/08/us/politics/08townhall.html?th&emc=th).

Many Americans have continued the tradition that President Obama has set in conducting town-hall meetings to discuss the healthcare reform issue and attempting to set resolutions. However, these town-hall meetings have become the center-stage for bitter rivalry between Americans with differing opinions, who support different reform plans.

In August, the White House expressed a willingness to support a reform proposal different from the one Barack had originally formulated during his election campaign. White House officials have stated that the public option of Obama’s proposal may be omitted, in an effort to maintain Republican support on Capitol Hill. The Secretary of Health and Human Services, Kathleen Sebelius, stated that the public option was “not the essential element” to Obama’s reform plan. She suggested cooperatives, rather than the public government plan reminiscent of Medicare (www.nytimes.com/2009/08/18/health/policy/18talkshows.html?scp=4&sq=health&st=cse). This decision may polarize the Democrats and certainly has many in question. Speaker Nancy Pelosi refused to alter her platform in support of a government-run healthcare program despite conceding standpoints in the White House.

As debate of serious flaws in the healthcare reform movement is under way in Congress and in the White House, civilians have attempted to be more expressive of different agendas. Town hall meetings have not only become branded as rowdy, oftentimes occupied by violent, rambunctious crowds of Americans, but has recently become a stage of provocation and intimidation way beyond scuffles and fistfights. One man in New Hampshire began a trend to bear arms and claimed to have defended the 2nd Amendment’s right to bear arms at a protest in front of a town-hall meeting, where President Obama was to speak on healthcare reform. On August 17, a crowd of about a dozen people gathered at another protest at the location where the President would participate in town-hall meeting on healthcare reform in Arizona. One man on this particular occasion ported a military-style rifle. Critics of this phenomenon contend that bearers of arms who attend these protests are merely provoking fear and discouraging meaningful, unrestrained discussion.

The passage of Medicare was one of the first major healthcare reform advances in U.S. history. Now, in 2009, healthcare reform is brought back into question, in part due to a combination of recession, the outbreak of the H1N1 epidemic, rising costs of healthcare and medications, unemployment, loss of insurance plans, and the priorities of the Obama Administration and the 111th Congress. The debate for healthcare reform has in the past, as it has now, evolved into both a political issue and social movement for change (www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1447696).

Below is an outline of the major proponents of each of the proposed bills (www.cbsnews.com/stories/2009/07/28/politics/main5194087.shtml?tag=latest):

Healthcare Reform Proposals

1) The House Democratic Bill

Approximately 94 percent of non-elderly U.S. residents will be covered (an increase from the current 81 percent).
The plan will cost about $1.5 trillion over 10 years.
Revenue-raisers will include new income taxes on singles earning more than $280,000 per year and couples earning more than $350,000 per year.
$500 billion cuts in Medicare and Medicaid.
Requirements: Individuals must have insurance or pay a tax penalty of 2.5 percent of income. Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll.
Individuals and families with an annual income up to $88,000 for a family of four will receive subsidies to help them purchase coverage.
A new Health Insurance Exchange will be created to assist individuals and families decide on health insurance.
A standard benefits package would include preventive services, mental health services, oral health and vision for children. Out-of-pocket costs will be capped.
The plan is government-run and public, made available through insurances exchanges run by the secretary of Health and Human Services.
By 2013, Medicaid will cover all non-elderly individuals with an income up to $14,404.

2) The Senate Health, Education, Labor and Pensions Committee

Approximately 97 percent of Americans will be covered.
The plan will cost about $615 billion over ten years (not the complete estimate – it is only a part of a larger Senate bill).
The Senate Finance Committee will determine the funds of the plan.
Requirements: Individuals must have insurance or pay a penalty tax. Employers who don’t offer coverage will pay $750 per year per employee without coverage. Smaller businesses (with 25 persons or less) are exempt.
Subsidies will be available to families with an income less than $88,000 per year.
Health plans must offer a benefits package (what it will consist of is currently undetermined).
The new public plan would compete with private insurers.
Individuals and small businesses will be able to buy insurance from American Health Benefit Gateways.
Would create a new voluntary insurance program with a modest daily cash benefit to disabled people to stay in their own homes, rather than going to nursing homes.

3) Bipartisan “Group of Six” – Six Senators on the Finance Committee

97 percent of documented Americans would be covered.
Would cost approximately $1 trillion over 10 years.
The plan would be funded by cuts to Medicaid and Medicare, a tax of 35 percent on high cost health insurance policies, $90 billion of revenue will be obtained by taxing health insurance companies on policies valued $25,000 or more.
Requirements: Individuals are required to get coverage. Employers are not required to provide coverage, but would face a penalty based on how much the government would pay for individual coverage.
Subsidies would be provided to families earning no more than $66,150 per year.
The government will not enforce benefits.
This plan is the only bipartisan plan. Republicans are not in favor of a government-run plan. The compromise would include nonprofit member-owned co-ops to compete with private insurers.
State-based exchanges will provide assistance with choosing health insurance.

4) House Republicans

There are no estimates provided regarding how many people will be covered.
The cost of the plan is also currently unknown.
The House GOP does not propose any new taxes, but will reduce Medicare and Medicaid.
No requirements for individuals or employers.
Tax credits would be offered to “low- to modest-income” Americans. Assistance would be offered to low-income retirees.
The benefits package includes that children remain covered under their parents’ insurance through age 25.
No government-run public plan is proposed.
No purchasing exchange is proposed.

5) The Obama Administration

a) Obama’s Campaign Proposal

All children and many now-insured adults would be covered.
The cost is approximately $1.6 trillion over 10 years.
There would be cuts on the healthcare system and raised taxes on households with an annual income of $250,000 or more.
Requirements: Parents must provide insurance to their children. Employers of large businesses would have been required to provide coverage to their employees.
Subsidies would have been given to low-income Americans.
A new National Health Exchange would be created to assist Americans in finding insurance plans to purchase.
The plan would have been government-run and public.
Medicaid eligibility would have been expanded.
Obama/Biden Election Platform: www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf
The President’s Fact Sheet on his healthcare reform plans: www.whitehouse.gov/omb/fy2010_key_healthcare/

b) Progress so far:

On February 4, 2009, President Obama signed the Children’s Health Insurance Reauthorization Act, which provides healthcare to 11 million children (4 million were previously uninsured) (www.healthreform.gov/forums/features/index.html).
On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA), which “protects health coverage for 7 million Americans who lose their jobs through a 65 percent COBRA subsidy.” The ARRA utilizes $19 billion in computerized medical records; $1 billion for prevention and wellness; $1.1 billion for medical research; $500 million for training in healthcare for doctors and nurses.

Healthcare Coverage in the Latino Community

Latinos face various challenges in healthcare and have certain concerns in the healthcare reform debate. There were approximately 44.3 million people of Hispanic/Latino heritage in the United States in 2006 (www.cdc.gov/nchs/fastats/hispanic_health.htm). Many Latinos are currently uninsured – approximately 32% of Latinos under the age of 65. Under Medicaid, only legal U.S. residents are covered. This means that undocumented immigrants are likely to be uninsured and not covered by public healthcare programs, such as Medicaid.

Medicaid is especially important now, during this critical recession era, when individuals are getting laid off and lose the health insurance plans provided by their former employers. Many children of undocumented immigrants depend on Medicaid for healthcare. Latinos compose 22% of the United States population under the age of 18 (pewhispanic.org/reports/report.php?ReportID=110). Even Medicaid, which has served as a “critical safety net” for the uninsured may become unreliable – especially when state governments budget Medicaid coverage expenses according to state budgets and have varying policies of eligibility.

Healthcare is an increasingly more important issue in the Latino community. By 2050, Latinos will compose a quarter of Americans between the ages 50-69, making healthcare accessibility a concern especially for Latinos age 50 and older (news.newamericamedia.org/news/view_article.html?article_id=21a1c828283de4f5ab6284abd8b6beee). According to a report on health and financial security from the AARP, more than one-quarter of Hispanics/Latinos in 2004 regarded physical health as most important to them, second to relations with family and friends. This report also stated that quality and affordable healthcare coverage is a concern and challenge for Latinos, especially those of 50 years of age and older. Eight in ten Latinos age 55-59 felt that the cost of healthcare insurance and medical expenses is a challenge for individuals age 55 and older.

Lawmakers have been rigorously working on the nation-wide issue of healthcare and have recently proposed several bills. None of these bills would extend healthcare insurance coverage to undocumented immigrants, which might become problematic in the Latino community. Recent immigrants may not be eligible for programs such as, Medicaid and SCHIP; however, they may be eligible for other government-funded programs, including the Special Supplemental Nutrition Program for Women, Infants, and Children; Food Stamps; and Unemployment Compensation (bixbycenter.ucsf.edu/publications/files/LatinoYouth_Access_2002.pdf).

Misconceptions about healthcare are also barriers to quality healthcare in the Latino community. Latinos who may be eligible for Medicaid and the State Children’s Health Insurance Program (SCHIP) may be steered away from utilizing these programs because of misconceptions regarding eligibility, stigma and quality of care, and language and cultural barriers (bixbycenter.ucsf.edu/publications/files/LatinoYouth_Access_2002.pdf).

Latinos suffer from numerous health problems, more so than other cultural groups in the United States. The National Institute of Health (NIH) state that Latinos suffer from health disparities in deaths related to a number of medical problems, including obesity, asthma, lung cancer, liver cancer, stomach cancer, diabetes, cardiovascular disease, stroke, and HIV/AIDS. In 2008, the NIH reported that 10.4 percent of Latinos over the age of 20 had diabetes (ndep.nih.gov/media/FS_HispLatino_Eng.pdf). As a population that faces a variety of health problems, Latinos are expectedly concerned about healthcare.

The economic crisis that the U.S. has been facing drastically affects the Latino community. The Bureau of Labor Statistics of the U.S. Department of Labor released an Employment Situation Summary for the month of June 2009, reporting unemployment rates based on race and ethnicity. The reported nationwide unemployment rate was 9.5 percent, 14.7 million Americans (www.bls.gov/news.release/empsit.nr0.htm). For the same month, 12.2 percent of Latinos were unemployed, second only to the black population at 14.7 percent. The COBRA law assures that laid-off employees can utilize the healthcare plans offered by their former employers. The unemployed can use this source as well as unemployment insurance for only three to six months after losing their employment.

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