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Obamacare is no miracle drug for minority Americans

The federal Affordable Care Act will likely help many immigrants, but questions and hurdles remain. And minority populations start from a big deficit on health insurance.
Teresita Batayola, CEO of International Community Health Services, with Ron Chew of the International Community Health Services Foundation.

Teresita Batayola, CEO of International Community Health Services, with Ron Chew of the International Community Health Services Foundation. International Community Health Services

The National Korean American Service and Education Consortium and other groups campaigned for including immigrants in health care reform legislation.

The National Korean American Service and Education Consortium and other groups campaigned for including immigrants in health care reform legislation. Korean Resource Center/Flickr

Like most communities of color, Asian Pacific Islanders continue to experience worse access to health care than their white counterparts. That's linked to Immigrants being more likely to work at low-paying jobs and to have decreased access to employer-sponsored health coverage.

The Affordable Care Act enacted in 2010 by Congress and recently upheld by the U.S. Supreme Court extends health coverage to many of the millions who would otherwise remain uninsured.  How will the new health reforms affect the Asian Pacific Islander community in King County?

In King County, according to the most recent data, about 12 percent of Asian Pacific Islanders are uninsured, while the rates in Pierce County are much higher at 18 percent.  Although people of color represent one-third of the total U.S. population, they comprise more than half of the uninsured.

“Unfortunately, recent immigrants will see limited benefits from the Affordable Care Act,” said Teresita Batayola, chief executive officer of the International Community Health Services.  “Those who are here legally have to be here for five years to benefit from Medicaid programs unless they are pregnant women and children.”

“Some could benefit from participating in the health insurance exchange once it is established,” she said. “Theoretically, the exchange will have insurance plans available for all income ranges, but recent immigrants will not be able to get subsidized coverage.”

Those who already have coverage will see some improvements, such as no deductible or copays for preventive services and coverage of kids up to 26 year olds, Batayola said. “Immigrant benefits are equal to everyone’s benefits if they can afford health insurance on their own or have health insurance through their employer," she said.

Other improvements include free preventive care for seniors, tax rebates for small businesses, no lifetime dollar limits on benefits, elimination of the prescription “donut hole” coverage gap for the more than 1 million Washington seniors on Medicare, federal review of unreasonable increases in health insurance premiums, and expanded coverage for early retirees.

“Organizations providing medical care will be required to put more effort into preventive services and coordination of care, which should improve the care received by everyone, with particular benefit for families with lower education, with limited English skills, or with particularly complex medical situations,” said Susan Allan, director of the Northwest Center for Public Health Practice and associate professor at the University of Washington School of Public Health.

Families will also benefit from other provisions of the law, such as the option to cover adult children on a parent’s policy until the age of 26.

The new law allows individuals with incomes above 133 percent of the federal poverty level to purchase coverage through a newly-created health exchange if employer-sponsored coverage is not available. The Affordable Care Act expands Medicaid eligibility to include most individuals with incomes up to that level, including men and childless adults.

“Also, the lifetime limits on how much medical care a person can get will no longer be allowed,” Allan said.  “Currently wealthy families can tap into their own resources at that point, but families without lots of wealth can face very difficult situations if an insurance company decides that they have hit the limit of coverage for someone with complex cancer or with mental illness.”

Undocumented immigrants are likely to face continuing hurdles getting assistance to reduce the costs of health insurance.

“One of the compromises that was made in getting support to pass the Affordable Care Act in Congress was that undocumented immigrants are not deemed to be covered under the terms of the act. There is some question whether because of how the law might be implemented, they may end up required to get insurance, but will not be eligible for the subsidies to reduce the costs.  But no one is sure at this point.  It is clear that persons who are not legal residents of the U.S. are specifically excluded, ” Allan said.


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Comments:

Posted Fri, Jul 27, 6:13 a.m. Inappropriate

What responsibilities do the sponsors of the LEGAL immigrants have? Illegal immigrants or undocumented if you prefer should not have access to subsidized care, just the emergency care authorized by Federal law. If you want to address health care costs you should start by checking the eligibility of those seeking the subsidy. There is currently up to 90 Billion dollars a year in waste, fraud and abuse in the Medicare/Medicaid system, isn't it about time we start addressing those who shouldn't even be in the system so we can be more proactive about taking care of those who are?

Cameron

Posted Fri, Jul 27, 6:57 p.m. Inappropriate

If, on principle, we deny health care to someone based on immigration status, does that mean we deny whooping cough immunizations, or TB treatments, or other public health treatments that are NOT included in Emergency room care?
After all, epidemics are a small price to pay for moral certitude.

Ries

Posted Fri, Jul 27, 8:23 p.m. Inappropriate

This is a good policy draft for beginning the next needed steps: Improving a very complicated law which, inevitably, doesn't achieve all possible benefits for all constituencies.

Welcome to the dysfunctional arena of American politics--and good luck addressing the very laudable aims you describe in much less than the 45 years it took (since Medicare/Medicaid in 1965) to accomplish even PART of health care and health insurance reform.

Your points are good ones, and summarize the real, unmet needs of millions of low-income, culturally and racially minority people who contribute substantially to the American economy and civic life.

The next question is: How can these issues be successfully advanced in a country that constantly wars with itself--between personal freedom, including the freedom from taxation and "socialization of costs" of any kind, and the vision of a kinder, gentler, equal-opportunity society?

Seneca

Posted Fri, Jul 27, 9:27 p.m. Inappropriate

Collin should have mentioned the biggest way the Affordable Care Act benefits uninsured immigrants -- through a major expansion and upgrade of the 1,200 or so federally qualified community health centers around the country. The law, along with the Obama stimulus package, allocated billions in new funding for the centers, which now serve about 20 million Americans a year and are projected to serve 40 million. They take all comers, on a sliding-scale payment basis, without regard to immigration status. The centers are the linchpin in serving the poor and uninsured. Until recently, they had strong bipartisan support. President George W. Bush just about doubled funding for them during his administration. But now, of course, the Republicans want to cut funding for the centers because they oppose all things Obama.

Posted Sat, Jul 28, 6:50 a.m. Inappropriate

Yes Ries, It means we deport those who opted not to follow legal immigration routes and deport them, immediately. Segment out those with contagious diseases, give them enough medicine to get back to their home countries or a country that will accept them and send them back. World-wide I believe you will find an infinite demand for "free" health care, it's simply not possible for the American taxpaying public to subsidize the health care needs of all those who are capable of running, walking, swimming or crawling across our borders.

Cameron

Posted Sat, Jul 28, 8:20 a.m. Inappropriate

Luckily, we have found a mechanism to do just that - its called a "Recession". Net immigration from Mexico has fallen to zero this year, and may even be negative.

However, public health does not work only on legal citizens- public health initiatives require that they be applied equally to all residents, legal or not, and all residents benefit from public health programs.

Deportation is currently way up, under Obama, but its being focused on criminals. The current administration is deporting between 30% and 50% more illegal or undocumented people than the former, Republican ones did.

But there is no political will in the USA to uproot another ten or twenty million americans, many of whom dont even speak any language but english, and send them back to countries that they have not lived in for most of their lives.
It wont happen.

And, while it isnt happening, we still have a moral and ethical responsibility to children and families, and yes, even adult males, as well as a practical and selfish need to keep everyone healthy.

Ries

Posted Sat, Jul 28, 11:08 a.m. Inappropriate

Great Ries, you pay for it. Stop making the people who are not being well served by their Governments immigration enforcement efforts, support the health care costs of people not legally eligible to participate.

How can you say there is no political will to up root ten or twenty million illegal aliens? When was the American public ever asked? When did we vote on allowing illegal aliens to come into the country and receive health care, public educations and welfare benefits?

There is no need to actively deport illegal aliens, they will leave on their own if motivated. Motivated by losing all medical benefits, child support, Welfare payments and educational benefits. We can also inspire illegals to return to their homeland if the Federal Government announced that in December 2013 any assets or real property in possession of illegal aliens will be subject to confiscation by the Government to cover the costs of immigration enforcement.

We have an immigration process, if millions have chosen not a follow that process, why should we reward that behavior with Government Support?

Cameron

Posted Sun, Jul 29, 3:52 a.m. Inappropriate

We do have an immigration process -- and it is so convoluted, backlogged and arbitrary that it is simply unreasonable to expect people to comply with it. We've made it impossible for people to immigrate legally, so we should drop the self-righteous complaints about the ones who don't jump through our bureaucratic hoops.

Aaron30

Posted Sun, Jul 29, 5:08 a.m. Inappropriate

Go ahead and bankrupt the process and the country. If it's "impossible" for people to immigrate leaglly, how is it that Millions have managed to do so? Self-righteous or Self-preserving? Please give us some examples of Countries that don't make people "jump through bureacratic hoops" You know silly things like health screenings, Criminal background checks, literacy, The ability to function in society without Government Subsidies. If you don't want or need any form of Sovereignty as a Country, no standards, no rules for entering or leaving because they are just too hard, then do you really have a Country?

Cameron

Posted Mon, Jul 30, 5:33 p.m. Inappropriate

Our current health care system is bankrupting the country.
Every other industrialized, civilized nation has some sort of universal health care.
And all of them pay in the vicinity of HALF of what we pay.
And still manage to cover immigrants, legal or not.

So, saving about 8% of our GDP makes sound economic sense to me.

Also, every other industrialized, civilized nation actually has MORE government subsidies for immigrants than we do.

There are hundreds of thousands, probably millions, of undocumented ("illegal") people in the USA who have no memory whatsoever of their birth country, dont speak its native language, have never been there, and would definitely NOT leave on their own- as they have no place they have ever known but the US, and many are under 18.
Again, even Reagan, the great hero of the Tea Party, instituted amnesty, as HE didnt have any interest in deporting millions.
There is no way it could happen now.

Certainly, the current Obama administration program of actually deporting convicted criminals, which Bush failed to do, is a good thing, and should be continued.
But deporting kids who grew up here wont help anyone. And there have been many studies and government numbers that prove that undocumented workers contribute, rather than deplete, our economy, and that the cost of deportation would far outweigh any monetary benefits from not paying for health care, schooling, and other "government subsidies".
It doesnt make economic sense, it doesnt make business sense, and it doesnt make moral sense.

Ries

Posted Fri, Aug 3, 4:04 p.m. Inappropriate

Obamacare is no miracle drug for minority Americans

Darn it. Was a special-interest group promised a miracle drug for minority Americans (are you sure "minority" shouldn't be capitalized?)?

Are you sure its not in there? Has anyone read it through?

BlueLight

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