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Impact of the Affordable Care Act on the Latino Community

National Hispanic Medical Association Meeting

Steven Weinberger, MD, FACPExecutive Vice President and CEOAmerican College of Physicians

Important baseline statistics>50 million Hispanics in US (17% of total US population)Fastest growing racial or ethnic population in USBy 2050: anticipated 30% of total populationCurrently: Hispanics have highest uninsured rate among racial/ethnic groups (~1/3 lack coverage)Source: Kaiser Family FoundationAdditional important statisticsHispanics are a younger population than non-Hispanic Whites47% of Hispanics are 65 years old (6% vs. 18%)76% of all Hispanics and >90% of Hispanic children are US citizensSource: Kaiser Family FoundationIncome/employment statisticsNon-elderly Hispanics as likely as non-elderly, non-Hispanic Whites to have a full-time worker in the family, but more likely to be in low-wage blue-collar jobs and to have low family incomeMore than half (53%) of non-elderly Hispanics employed in agriculture, service, or construction industries1 out of 3 Hispanics have family income below poverty level (compared with 1/7 non-Hispanic Whites)Source: Kaiser Family Foundation

Insurance coverage statisticsHispanics tend to be employed in jobs that do not offer employer-sponsored insuranceWhen offered, often not affordableHispanics account for ~1/3 of total non-elderly uninsured2011 data: 15.5 million uninsured non-elderly Hispanics (~12.6M adults, 3M children)7 in 10 uninsured Hispanics are in families with at least 1 full-time workerSource: Kaiser Family FoundationMore insurance coverage statisticsHispanics ~half as likely as non-Hispanic Whites to have private health insurance (39% vs. 71%)Hispanics >twice as likely as non-Hispanic Whites to be uninsured (32% vs. 13%)MedicaidCovers >1/2 Hispanic childrenMuch more limited role for adultsSource: Kaiser Family Foundation

Opportunities provided by ACAMedicaid expansion: initial plan for expanding eligibility to incomes up to 138% of poverty levelSupreme Court ruling: expansion a state optionPurchase of insurance through health insurance exchangesPremium tax credits available to help moderate income individuals pay for coverageSource: Kaiser Family FoundationImpact of ACA on Hispanic coverageNearly all uninsured Hispanics would qualify for either Medicaid expansion or tax credits57% have income below Medicaid limitAdditional 38% could receive tax subsidies to purchase coverage through exchangesBut non-citizen Hispanics face eligibility restrictions46% of uninsured Hispanics are non-citizens (lawfully present or undocumented immigrants)

Source: Kaiser Family FoundationLawfully present immigrants areSubject to 5-year waiting period before eligible for Medicaid and CHIP~1/2 states have eliminated waiting period for lawfully present children and pregnant womenThese eligibility restrictions remain in place under ACAAble to purchase coverage on exchanges (and receive tax credits) without a waiting period

Source: Kaiser Family FoundationUndocumented immigrants areIneligible for Medicaid nowIneligible for Medicaid under ACA Ineligible for premium tax credits under ACAProhibited from purchasing exchange coverage at full costNote: states may provide state-funded coverage to documented or undocumented immigrants, but without federal matching funds

Source: Kaiser Family Foundation12Numerical impact of ACA on coverage of pre-ACA uninsured population