With one in three U.S. Hispanics lacking health insurance, it's little wonder recent nationwide surveys show that the Hispanic population considers healthcare reform to be the No. 1 issue of the day — surpassing even immigration reform and the economic downturn. Now, with a historic effort underway on Capitol Hill to merge two recently approved health bills — the House's in November and the Senate in late December — the implications for Hispanics are monumental.
Both bills seek to significantly boost the rate of insured Americans, currently at 83 percent. The Senate plan would expand that coverage rate to 94 percent; the House plan, 96 percent. Put another way, the bills would reduce the number of uninsured people in the United States – now standing around 46 million – by between 31 million and 36 million. "I think it's a phenomenal step forward," Dr. Elena Rios, president and CEO of the National Hispanic Medical Association, told HispanicBusiness Magazine. "It's really a big opportunity for this country to start decreasing the cost of healthcare."
But Hispanic advocates are far from sanguine. As lawmakers in Washington D.C. gear up for a grueling effort to reconcile the gargantuan bills, major concerns still loom for Hispanic groups. Their worries are numerous, but in general, Hispanic groups tend to be less enthusiastic about the Senate bill. Take the politically thorny issue of illegal immigration. Currently, the Senate bill prohibits illegal immigrants from purchasing — with their own money (and no government subsidies) — health plans on a proposed national insurance exchange. An insurance exchange is a large pool of people that contracts with insurers to lower risk and therefore reduce the premiums of the customers.
"Individuals who have the money ought to be able to purchase any product they need," said David Ferreira, vice president for government affairs at the U.S. Hispanic Chamber of Commerce.
"In our country, you don't prohibit somebody from buying bread based on immigration status." Health insurance, he added, should be no different. In contrast to the Senate's ban – which also applies to legal residents of the U.S. Commonwealth of Puerto Rico – the House version allows illegal immigrants and citizens of Puerto Rico to participate in the exchange. Both bills, however, include language prohibiting those groups from receiving federal subsidies.
And then, of course, there is the political hot button of the public option. As is, the Senate bill includes no government-run health plan, while the House bill does. "I think the public option would be a very viable mechanism," said Castulo de la Rocha, CEO of AltaMed Health Services, a network of community health centers for the poor in Southern California. "I'm always interested in assuring there are multiple options – that people have choice."
Also troubling to many Hispanic organizations is how neither bill deletes the current five-year ban on newly documented immigrants from enrolling in Medicare or Medicaid.
Meanwhile, for all the noise in the media about sweeping issues, such as illegal immigrants and the public option, in many cases it is the lesser-known potential changes that offer a more concrete illustration of what a post-reform world would look like.
Both bills, for instance, would not only drastically reduce the number of uninsured Hispanics, but also dedicate loads of money to preventative care — a key issue for Hispanic advocacy groups. They also would expand the safety net for the poor and take measures to increase the woefully low numbers of Hispanic doctors and nurses.
