Moises Enriquez and María T. Soto both migrated to Ohio from Humacao, Puerto Rico six months ago, and both are struggling to cover their health care costs. While Ms. Soto has Medicaid and Medicare insurance, Mr. Enriquez has no health insurance and did not qualify for Medicaid.
They attended a community health forum at Lorain’s El Centro de Servicios Sociales, Feb.1, 2012, to learn more about available health insurance plans.
Speaking to a crowd of over 30 people, Mayra E. Alvarez, of the U.S. Department of Health and Human Services, said President Barack Obama’s Affordable Care Act is holding health insurance companies accountable and granting “more Americans, more Latinos” access to health care.
The federal law, signed by Obama in March of 2010, places multiple federal regulations on health insurance companies including preventing them from denying coverage to patients because of pre-existing conditions. Though most regulations have already rolled into effect, all will fully go into effect in 2014.
The Affordable Insurance Exchange, beginning in 2014, will allow individuals and small business owners to “shop around” and purchase a health insurance plan that best suits their needs.
“If there are changes (to the regulations on health insurance plans), you can’t take advantage of them because you don’t know they exist,” Mr. Enriquez said “There is nothing better than being informed.”
Ms. Alvarez said Latinos are the most uninsured and are a community underserved in health care.
One in three Latinos in the U.S. does not have access to health insurance, and 1 in 2 Latinos in the country does not have access to a consistent doctor or a family doctor, Alvarez said.
She said there are roughly 34 million U.S.-Americans and 9 million Latinos in the country without health insurance.
“It’s inexcusable for people to not have access to health care when it’s tied to every piece of our well being,” said Ms. Alvarez, director of Public Health Policy in the Office of Health Reform.
Latinos are also not investing in preventative care services but instead are using the emergency rooms as a last resort, often when their illness has advanced to the late stages, Alvarez said.
“As a result of that, they get sicker, and die sooner,” Alvarez said “If you look at rates across these – breast cancer, cervical cancer, diabetes, heart disease, our Latino community is often one of the hardest hit, and what’s most tragic is that many of these illnesses are preventable.”
Alvarez said the Affordable Care Act’s goal is to grant access to health care for these underserved communities. More Latinos should go to the doctor and participate in preventative care, she said.
The Affordable Insurance Exchange is a notable component of the Affordable Care Act to take place in 2014. The exchange is a transparent and competitive health insurance marketplace available online. If an employer does not offer health insurance, individuals and small business owners will be able to directly purchase a health insurance plan that best fits their specific needs. The exchange lists insurance plans by state, and plans that meet certain benefits or costs standards.
The websites, Healthcare.gov in English or CuidadodeSalud.gov in Spanish, run by the federal government, currently list all the available health insurance plans throughout the country. In 2014, only those plans meeting the federal government’s ground rules will be listed, Alvarez said.
The Affordable Care Act, Alvarez said, was meant to protect and better inform the consumer on what exactly is being purchased within their health insurance plans.
Alvarez said the law is “doing away with some of the worse insurance company abuses,” like denying children’s or adults’ coverage because of pre-existing conditions, and the insurance company’s ability to end an individual’s coverage “for no apparent reason,” or because of paperwork errors.
But because those regulations will not fully go into effect until 2014, the federal government has recommended a new pre-existing conditions insurance plan available in all 50 states, run by the states or federal government. It is available by visiting pcip.gov.
Alvarez said there are 130 million US-Americans living with pre-existing conditions, like Enriquez, who said he will attempt to apply for that insurance plan.
The law would limit the insurance companies’ ability to use the consumers’ premium dollars for administrative purposes or their ability to raise premiums without a just cause. Before the law, they could spend 60 percent on administrative costs. The law instead would require the companies to spend 80 percent of the premium dollars on actual medical care or the improvement of medical care services. “If they don’t, you get a rebate,” Alvarez said.
Alvarez said the Affordable Care Act has allowed 2.5 million young adults up to the age of 26 to stay on their parents’ health insurance plan.
Plus, she said the law is making an $11 billion investment into community health centers in underserved communities throughout the country and expanding the health care workforce in those areas. The medical staff or doctors choosing to stay in these underserved communities for two or four years are having their student loans repaid, she said.
Alvarez said the law is strengthening the Medicare program by eliminating cost sharing requirements and by re-shifting tax dollars to focus on fraud and abuse.
El Centro’s Executive Director Victor Leandry said he and his team are “very excited” that the agency’s vision has become a reality: using the community room within their new building for hosting these types of educational events. Many more organizations are in line to provide educational programming at the agency, to be announced in the near future.
“That is crucial for this community,” Leandry said.
Access to health care, Leandry said is “a topic that I think is very important for the Latino community.”
Check La Prensa for future events at El Centro.
Vea este artículo en español la próxima semana.