Latino Health Disparities and the ACA

1. Latino Health Disparities and the ACA Senator Irene Aguilar, MD

3. Table 2: Estimate of ACA Effect, 2016 → → → Source: Dr. Jonathan Gruber’s analysis for the Colorado Health Benefit Exchange, 2011

4. 22% 39% 29% 10% Dr. Jonathan Gruber 9/16/11

6. Federal Poverty Level Among the Uninsured, Colorado 2011

7. Massachusetts: Private, Medicare & Medicaid Payment for Professional Procedures Private Payer Payment Variation Source: Massachusetts Division of Health Care Finance and Policy, Massachusetts Health Care Cost Trends: Price Variation in Massachusetts Health Care Services, May 2011.

8. Determinants of Health 2011 U.S. Healthcare Spending: $2.7 Trillion

9. Number of U.S. Deaths from Behavioral Causes

10. Smoking prevalence by race and ethnicity 2008-2012, Colorado adults Percent Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment

11. Obesity prevalence by race and ethnicity 2008-2012, Colorado adults Percent Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment

12. Diabetes prevalence by race and ethnicity 2008-2012, Colorado adults Percent Source: Colorado Behavioral Risk Factor Surveillance System, Colorado Department of Public Health and Environment

13. Source: Small Area Income and Poverty Estimates (SAIPE) , US Census Bureau

14. Colorado unemployment rates, 2010

15. Colorado high school graduation rates, 2011 Source: Colorado Department of Education

16. Years of potential life lost Source: Vital Statistics Unit, Colorado Department of Public Heath and Environment

17. A Uniquely Colorado Solution:The Colorado Health Care Cooperative

19. US v. Other G7 Countries Updated OECD website : http://stats.oecd.org/index.aspx The spending per capita numbers were converted from the currency of the country to US dollars by a PPP index. ORIGINAL BY: John A. Nyman, PhD University of Minnesota

20. IOM: Best Care at Lower Cost 7.2% 9.8% INSTITUTE OF MEDICINE 2012: US Health Care Annual Waste $ 765 Billion 27.5% 24.8% 17% 13.7%

21. Concentration of Health Care Spending in the U.S. Population, 2009 Percent of Total Health Care Spending (≥$51,951) (≥$17,402) (≥$9,570) (≥$6,343) (≥$4,586) (≥$851) (<$851) Note: Dollar amounts in parentheses are the annual expenses per person in each percentile. Population is the civilian noninstitutionalized population, including those without any health care spending. Health care spending is total payments from all sources (including direct payments from individuals and families, private insurance, Medicare, Medicaid, and miscellaneous other sources) to hospitals, physicians, other providers (including dental care), and pharmacies; health insurance premiums are not included. Source: Kaiser Family Foundation calculations using data from U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey (MEPS), Household Component, 2009.

23. What is a Health Care Cooperative? • A nongovernmental, nonprofit, member- owned and operated corporation • Residents of Colorado are the owner-members • The cooperative operates for the benefit of Coloradans—providing quality health care for all, while saving members’ money It’s not a farm or electric cooperative.

25. Figure 4. Share of Colorado population without health insurance coverage, alternative funding programs, 2015-24.

26. Savings under the Cooperative come from reducing administrative waste SAVINGS: 2016: $7.7 billion @ 16% 2024: $ 24 billion @ 28%

27. Cooperative would put Colorado on sustainable path: Spending growing no faster than the GSP Savings grow by “bending the cost curve” by reducing administrative share and restraining drug price inflation

28. Martin Luther King, Jr. Cowardice asks the question: is it safe? Expediency asks the question: is it politic? Vanity asks the question: is it popular? But conscience asks the question: is it right? And there comes a time when one must take a position that is neither safe, nor politic, nor popular- but one must take it simply because it is right.