Latino Workers Want Low-Cost Insurance
To assess Latinos' value of health insurance and their experiences with job-related health issues, a new Commonwealth Fund-sponsored study hosted focus groups composed of 81 low- and moderate-income Hispanic adults. Twenty-two insured and 59 uninsured Hispanics participated in eight focus groups conducted in Chicago; New York; Los Angeles; San Antonio; Frio County, Texas; and Riverside County, Calif. Most focus group participants had annual household incomes of $35,000 or less. According to the study, Hispanics want comprehensive health insurance, but employers either do not offer it or the cost is too high "relative to the benefits" and "the perceived need for medical care." For some Hispanics, buying health coverage "takes a back seat" to basic needs, such as food and housing. For others, securing a job, even if it does not offer coverage, is the "first priority." Some Hispanics also cite their youth and relatively good health or negative experiences with health insurance in the past as reasons for not purchasing insurance.
According to the focus groups, language barriers prevent many Hispanics from understanding insurance forms and other materials that are not written in Spanish. And concerns about being questioned regarding immigration status also play a role in Hispanics' lack of health coverage. But Hispanics who do have insurance, those who have children and those who have paid large medical bills out-of-pocket or have chronic health care needs value insurance more than Hispanics who do not, the research finds. Focus group participants who lacked insurance indicated that they want low-cost, comprehensive coverage, but not necessarily free coverage. Furthermore, while participants said they "liked the idea of payroll deductions in the existing employer-based insurance model," they disliked the fact that the coverage was tied to "keeping their job." Many focus group participants were unfamiliar with the CHIP program, but would be interested in receiving information about it.
The study recommends that policy makers identify "more affordable and comprehensive coverage options" than those in the current employer-based model, but also investigate models that would be "viable" for small employers to offer. Furthermore, the study suggests policy makers translate "all health care materials" into Spanish and target low- and moderate-income Hispanic families "with information about public programs for which they might qualify." The study notes a limitation: that focus groups "are not representative of how all Hispanic workers may feel about this topic." Project HOPE conducted the "quantitative" portion of the study, due out soon, which analyzes national databases to determine sociodemographic and employment characteristics of uninsured and insured Hispanic workers and reasons why some might not have coverage (Perry/Kannel, "Barriers to Health Coverage for Hispanic Workers: Focus Group Findings," 12/2000). The Commonwealth Fund study is available at http://www.cmwf.org/programs/minority/perry_barriers_425.pdf