The Potential of Federal Legislation to Reduce Latino Health Disparities

1. The Potential of Federal Legislation to Reduce Latino Health Disparities NALEO Latino Legislative Forum on Health Disparities Presentation by Jennifer Ng’andu December 8, 2007

2. Recent Trends in Federal Investments • Investments in health services that eliminate health disparities have been inadequate. • Specific programs that impact racial and ethnic minorities, such as REACH, minority health professions programs, and Office of Minority Health are either unfunded or underfunded. • Latinos face inadequate access to even those programs targeting the underserved.

3. Opportunities at the Federal Level The 2007 legislative debates have focused on children. • The State Children’s Health Insurance Plan (SCHIP) Reauthorization had the potential to increase access to health coverage. • Community-based programs targeted towards children and pregnant women can successfully connect Latinos to health coverage. • Ongoing opportunities to create health coverage equity for legal immigrants.

4. Background: Demographics • Latino children are the fastest-growing racial and ethnic youth group in the U.S. • Latino children represent one in five children (20.5%) in the U.S. • Most 2000 Census projections on Latino children’s population percentage growth by 2020 have already been surpassed. Source: U.S. Census Bureau

5. Background: Coverage Disparities • Latino children drastically uninsured. • One in five Latino children are uninsured year-round (22.1%) compared to 14.1%non-Hispanic Black (7.3%) non-Hispanic White children. • More than two-thirds (68%)of the uninsured children that are in fair or poor health in the U.S. are Latino. Source: U.S. Census Bureau; Urban Institute

6. Background: Access Disparities • Access to health insurance is a great predictor of whether or not children have access to health care. • Insured Latino children are nearly two times more likely (75%) to have a usual source of care than Latino children without coverage (41%). Source: Center for American Progress

7. SCHIP Can Make A Difference • Public health coverage is already and important source of coverage for millions of Latino children. More than seven million Latino children are enrolled in either SCHIP or Medicaid • Studying Latino children enrolled in SCHIP, of the 66% of Latino children who did not have usual care prior to enrollment, 92% had a usual source of care after being enrolled in SCHIP. Source: Congressional Research Service; Pediatrics (Shone, 2005)

8. SCHIP: “CHAMP Act” • The “Children’s Health and Medicare Protect (CHAMP) Act (H.R. 3162)” passed in July 2007. • CHAMP Act was a comprehensive approach that addressed a range of health access issues affecting Latinos. • The CHAMP Act made key investments that funnel new funding to states.

9. SCHIP: “CHAMP Act” • Provides $100 million for a national campaign to specifically enhance enrollment of vulnerable communities, including Latinos and other underserved minorities. Specific provisions modeled after the “Community Health Workers Act” invest resources in community-based outreach and enrollment efforts.

10. SCHIP: “CHAMP Act” • Enhanced federal match rate for the provision of health care services, including application and enrollment efforts. States would receive at least 75% match with an even better rate if their current federal match is higher. • States and providers are given incentive encouragement to offer language services.

11. SCHIP: “CHAMP Act” • Inserted language of the “Legal Immigrant Children’s Health Improvement Act (S. 764, H.R. 1308)” addressing inequitable access for legal immigrant children and pregnant women. • An estimated 400 to 600 thousand legal immigrants are ineligible for other health care services in this public programs. • The CHAMP Act is a boon to states: 21 states, plus the District of Columbia already provide legal immigrants partial or complete coverage with their own dollars. *Note: There is considerable confusion among legal immigrants about accessing Medicaid and SCHIP, because of varying immigration laws.

12. SCHIP: Current Status • A Senate bill with considerably weaker provisions passed and was used as the primary foundation for a compromise between both Houses. • While it promises to address Latino priorities, there was distinct political maneuvering that hinged on unfounded attacks of immigrants that seek to isolate these communities and weaken public health coverage access for racial and ethnic minorities. • NCLR issued opposition to final negotiated bill.

13. About NCLR’s Health Policy Engages in macro-level federal policy to ensure that the U.S. government makes investments. • Key issues are: • Increasing Access to Health Coverage • Eliminating Barriers to Quality Care • Addressing Social Determinants of Health (e.g. hunger and obesity)

14. About NCLR’s Health Policy • The NCLR Affiliate Network is critical to policy development. Approximately, one-third are community-based organizations engaged in providing direct health services. • For more information: www.nclr.org/health

15. About NCLR’s Health Policy • For more information, contact: Jennifer Ng’andu Senior Health Policy Analyst jngandu@nclr.org (202) 785-1670