By Katie Kerwin McCrimmon
Latinos, who are uninsured at disproportionately high rates in Colorado, could gain the most as health reform takes hold.
That’s what happened in Massachusetts, which in 2006 became the first state in the nation to require health coverage for all individuals and to implement a health insurance exchange.
Massachusetts’ health reform law became a model for the Affordable Care Act, which the U.S. Supreme Court last month upheld.
“A lot of Latinos have low-paying jobs and they don’t qualify for Medicaid,” said Maria Gonzalez, spokeswoman of Health Care for All Massachusetts, a consumer advocacy group that helps people find health insurance.
“Before health reform in Massachusetts, one in four Latinos didn’t have health insurance. By 2010, 96 percent of documented Latinos had health insurance,” Gonzalez said.
In Colorado, about one-third of Hispanics are uninsured, according to the Colorado Health Access Survey’s (CHAS) latest results from 2011. The survey found that Hispanics were more likely to be uninsured than Anglos or African Americans.
The CHAS is the most extensive survey of health care coverage in Colorado. A program of The Colorado Trust and conducted every two years by the Colorado Health Institute, the results are based on detailed surveys of more than 10,000 Colorado households that represent the state’s more than five million residents.
About 21 percent of Colorado’s 5.1 million people are Latino, according to U.S. Census data.
Neither the national health law, nor the Massachusetts health measure, provided for coverage for immigrants who had not entered the U.S. legally. (Related: click here to read Opinion:
In Massachusetts, hospitals worked with advocates to create a separate program to give health coverage to undocumented immigrants. In Colorado, undocumented immigrants often seek care at ERs or through community health systems.
This week, Gonzalez and other health navigators from Massachusetts came to Colorado to advise a newly-formed Colorado group called Adelante con la Salud: Latino Health Care Engagement Project. The group aims to improve health access among Colorado Latinos and to help people here understand the concept of a health exchange.
Colorado’s new exchange, an online health marketplace where consumers and business owners will be able to buy and compare health insurance plans, is slated to open in October, 2013 for plans that will start on New Year’s Day in 2014.
“Now that the (U.S. Supreme) Court has ruled, it’s time for everyone, including Latinos, to understand the benefits of the health care law,” Melanie Herrera Bortz, co-director for the new group, said in a statement. “Our organization believes the ACA will do for Colorado Latinos what the Massachusetts health care law did for Latinos there. We just need to educate our community. In Massachusetts, coverage for Latinos skyrocketed.”
Among those who got help there was Eugenio Hernandez, a legal immigrant from El Salvador who says health insurance saved his life. Hernandez had lived and worked in the U.S. for about twenty years and had paid taxes, but never had health insurance.
“One day, he was not feeling great and had to go to the ER, then was diagnosed with prostate cancer. He was really worried and didn’t know what to do,” said Maria Gonzalez of the Health Care for All program.
A hospital worker referred Hernandez to Health Care for All’s HelpLine.
“He was eligible for a subsidized program. He got high quality treatment and always says this program has saved his life. He’s a janitor. He doesn’t make much money. If it wasn’t for this reform, he never would have gotten health insurance.
“He pays a little premium and has access to some of the best hospitals in the country,” Gonzalez said.
While health costs have been soaring throughout the U.S. and Massachusetts has long had among the highest health costs in the country, Gonzales says health costs there have risen more slowly than elsewhere since Massachusetts mandated health coverage for all.
According to a study in the Forum for Health Economics and Policy, from 2006 to 2010, employer=sponsored health care premiums for a family rose about 19 percent in Massachusetts while they rose about 22 percent in the U.S. as a whole. Previously, from 2002 to 2006, family premiums in Massachusetts were rising at a faster clip than the rest of the country, increasing 40 percent in that period of time compared to nation increases of about 35 percent.
The study authors couldn’t prove that the cost savings were directly related to Massachusetts’ new health law.
But, a separate study has also found that more Latinos in Massachusetts now have a regular primary provider. That means that have a “medical home” where they seek most of their care, rather than relying on ultra-costly ER visits. Overall, that study found a 5 to 8 percent drop in ER use in Massachusetts.
Reaching out to people who needed health insurance proved to be one of the biggest challenges, Gonzalez said. People also need reassurance that they will get help finding the right insurance and that it will be a relatively quick process. Gonzalez said her navigators can finish the basic intake call with a person in less than 10 minutes.
“Once the exchange is actually running, they’ll see that it’s very easy,” she said.
One surprise was how much people wanted help from a live human being who could guide them through the process. She said her group expected to shut down their HelpLine a year or two after implementation of Massachusetts’ health law began. But, navigators there continue to get calls and have fielded more than 180,000.
“A barrier at the beginning is how to get the information across,” Gonzalez said.
Her group aggressively marketed to Latinos through ethnic media outlets and advertised their help center.
“If people just do a campaign right before (implementation) and expect everybody to jump in, that doesn’t work. It has to be ongoing.”
Today, Gonzalez said 98 percent of adults in Massachusetts are now covered while 99.8 percent of children have health insurance. About one percent of people pay a penalty for failing to get health insurance.
“Our first goal in Massachusetts was to get everybody covered. I think the country will be there too,” Gonzalez said. “People shouldn’t have to choose between putting food on the table and having health care.”