LATINOS: One-Third Lack Health Insurance, Study Shows

      Eleven million Latinos have no health insurance and often postpone or forgo medical treatment because of the high cost of care, according to a recent study by Kevin Quinn of Abt Associates. The study, "Working Without Benefits: The Health Insurance Crises Confronting Hispanic Americans," found that the number of uninsured Latinos more than doubled to 11.2 million from 1987 to 1998 -- accounting for an alarming one-quarter of the nation's 44 million uninsured. Moreover, only 43% of Latino adults and children are insured through employer-sponsored coverage -- a rate well below the national average of 64%. Of the 50 states, four -- California, Florida, New York and Texas -- account for 73% of all uninsured Latinos. Forty percent of Latinos residing in California and Texas lack coverage, as do more than one-third in Florida and New York. The study also revealed that at small firms or in low-wage jobs, Latinos are half as likely to have coverage and twice as likely to be uninsured as their white counterparts. Over the past 12 months, almost half of uninsured Latinos had not seen a physician when sick and went without prescription drugs and needed medical tests, according to the study. And an overwhelming two-thirds of uninsured Latinos faced collection agencies for outstanding medical bills (Quinn, "Working Without Benefits" report, 2/00). Karen Davis, president of the Commonwealth Fund, which funded the report, said, "The health of Hispanic working families in the United States -- particularly those at the low end of the income scale -- is suffering because too many don't even have the option of getting health insurance." Cathy Schoen, vice president of research and evaluation at the Commonwealth Fund, said, "Hispanics today comprise an increasingly vital share of the nation's workforce, a share that is certain to increase in the future" (Commonwealth Fund release, 2/18). By 2025, the Latino population in the United States will increase from 31 million to 59 million -- or from 11% of the population to a projected 18% (Quinn, 2/00). Schoen concluded that Latinos "appear not be receiving the same benefits as other working Americans" (Commonwealth Fund release, 2/18).

Not Eligible?
      Although more than four-fifths of Latinos who lack health care insurance have low incomes, many are ineligible for publicly funded insurance programs. Only 20% of Latinos with low incomes -- defined as income below 200% of the federal poverty line -- report having Medicaid coverage, often citing residency requirements as a barrier to coverage. Under current federal law, noncitizens without legal status are not eligible for public assistance health plans, except emergency services. Of the 11 million uninsured Latinos, the Immigration and Naturalization Services estimates that 3.5 million Latino Americans lack legal status. But noncitizens who have become legal U.S. residents since 1996 are barred from Medicaid for five years, regardless of need. Latinos with citizenship are uninsured at rates twice as high as their white counterparts and several percentage points higher than African Americans. In addition, the study cites the following as barriers to health insurance for Latinos:

• Many noncitizens are concerned about being labeled as a "public charge," and thus made ineligible for a green card;
• Latino families are more likely than whites or blacks to have two parents, excluding them from many Medicaid programs for low-income adults; and
• Medicaid eligibility standards are often well below federal poverty levels, excluding adults in working families who lack access to employer-sponsored coverage (Quinn, 2/00).