By Sergio Muñoz, Senior Policy Analyst, Health Policy Project
Health equity is about making the health system work for everyone. Broken policies contribute to widening health gaps in many communities that ultimately hurt our entire country. Indeed, a study by the Joint Center for Political and Economic Studies shows that more than $82 million was added to the health costs of Latinos during a three-year period due to health errors, premature death, and other inequities in health care. The cost of disparities for the entire nation reaches into the trillions. Recently, the Tri-Caucus—the Hispanic, Black, and Asian and Pacific American congressional caucuses—jointly introduced the Health Equity and Accountability Act of 2011 (HEAA), a comprehensive effort to alleviate health disparities that have long plagued millions of individuals in our health care system. One of the communities that this bill helps is the millions of immigrants who not only experience disparate treatment in health settings, but are also arbitrarily cut out of coverage.
The HEAA is designed to build on many of the gains of health care reform by continuing to chip away at coverage, access, and quality disparities that contribute to subpar health outcomes among racial and ethnic minorities. The HEAA also addresses the fact that many communities have intersecting demographic factors that make life even more complicated. A disabled racial or ethnic minority may be doubly impacted by disparities in health treatment, as may a member of the LGBT community of color. Minority immigrants are acutely affected by barriers that keep them from buying into our health insurance system. Uninsured noncitizens in particular, one-fifth of the national uninsured and 92% of whom are racial and ethnic minorities, have much to gain. The HEAA increases the study of this population and removes several access restrictions affecting immigrants. Crucially, along with striking the five-year waiting period for legal immigrants’ participation in public health and nutrition programs, the HEAA addresses the repercussions of nasty politics that snuck into last year’s historic health care reform.
Did you know that four out of ten undocumented immigrants already have private health insurance? It’s true. Did you also know that the health care reform law, the Affordable Care Act (ACA), included a provision that will prohibit these undocumented immigrants and others from buying unsubsidized private insurance in the new insurance marketplaces (Exchanges) in the future? Also true. The HEAA eliminates this over-the-top ban on the purchase of full-priced insurance.
To be clear: the HEAA only permits undocumented immigrants to buy private insurance from the Exchanges on their own—without any government subsidies. This is not an issue of undocumented immigrants receiving government tax credits or even getting a break on their co-pays—that’s prohibited elsewhere in the ACA. Instead the HEAA takes one very logical step forward by allowing any individual who bears the full burden of insurance costs to get into the health care system and share the risk, and eliminates unnecessary screening roadblocks for legal immigrants and citizens who have already been designated eligible for coverage.
The HEAA is the first major piece of federal legislation introduced after health care reform to approach the discussion of immigrant health care in a common-sense way—by removing this unprecedented barrier. NCLR is proud to support this effort. The late Senator Daniel Patrick Moynihan is often quoted for his observation that although everyone is entitled to their own opinion, no one is entitled to their own facts. Since we’re still waiting for a sound policy reason for increasing the ranks of the uninsured, and (most of us) agree that it’s wrong to allow the uninsured to suffer, this provision is entitled no deference. The Tri-Caucus commendably recognized this, the HEAA fixes it, and NCLR is proud to stand with its civil rights partners in full support.