Despite vital health
insurance coverage gains in California under the Patient Protection and
Affordable Care Act, Latinos continue to fall behind other racial and ethnic groups in
coverage and access to health care. A study by the UCLA Center for Health Policy Research finds that
Latinos are less likely to have health insurance due to lack of coverage
through an employer and barriers such as citizenship restrictions on access.
This lack of coverage also means that they have less access to health care
services, ultimately resulting in poorer health outcomes.
Using 2015 and 2016
California Health Interview Survey data, the study found that 13.7% of Latinos
in California remain uninsured. Although Latinos have one of the highest rates
of enrollment in Medicaid (or Medi-Cal in California) at 44.9%, 21.6% of
uninsured Latinos are also eligible to enroll in the program but are not
currently enrolled. Latinos also have the lowest job-based coverage rates out
of all racial and ethnic groups, with 31.6% reporting being insured through an
employer.
The study showed that 139,000
Latino children up to 18 years of age, or 76%, are eligible to enroll in
Medi-Cal but are not currently enrolled.
Nearly half of
uninsured Latinos under age 65 are not eligible to enroll in Medi-Cal, even if
their incomes fall below eligibility thresholds, because they are not citizens
or permanent residents. California legislation allows the state to fund health
care through Medi-Cal for residents regardless of citizenship status, but the
state needs to obtain a federal waiver to enforce the program, which will allow
only some Latino adults to enroll. It is important to note that not all of them
would qualify for Medi-Cal if eligibility is expanded to noncitizens and
nonpermanent residents, because some would have incomes that are above the
qualifying threshold for the program.
The study also found
that there were differences among Latinos in uninsured rates. Those of Guatemalan
descent (35.9% of Latino adults) and those of Salvadoran ethnicity (23.6%) are
the most likely to be uninsured. Latina women are less likely to be uninsured
than Latino men (15.9% versus 22.2%) and uninsured rates increase with age
(until age 55, after which these rates decrease).
Findings also show
that:
- Uninsured rates are higher among Latinos with fair or
poor health. And those who are not citizens or permanent residents are
more likely to be uninsured than U.S.-born Latinos (44.7% versus 16.5%)
- Uninsured rates were higher for Latinos who came to the
U.S. less than 10 years ago and those with low English proficiency
- Cost is an important factor in Latinos accessing health
care. A lack of money resulted in delays in seeking medical care or the inability
to fill a prescription.
“These findings show
that expanding Medi-Cal access to noncitizens would substantially reduce, but
not eliminate, the gap in uninsured rates between Latinos and other
Californians,” said Tara Becker, lead researcher of the study and senior public administration
analyst at the health policy research center.
“Despite high
employment rates, many California Latinos lack access to affordable coverage
through an employer and must purchase more expensive individual coverage on the
private market,” she said. “Eliminating the gap in coverage will require
reducing health care costs and expanding access to subsidies to purchase
coverage.”
“We hope the data from
the study can be used to inform health care policies that expand and promote
access to care for such an important segment of California’s population,” said
Robert Ross, president and CEO of The California Endowment.
This study was supported by The California Endowment.
The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health policy information for California. The Center improves the public’s health through high-quality, objective, and evidence-based research and data that informs effective policymaking. The Center is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit www.healthpolicy.ucla.edu.