California Healthline, October 24, 2012
California officials and health care providers are considering different strategies for treating immigrants who will remain uninsured after implementation of the federal health reform law, HealthyCal reports.
Under the Affordable Care Act, undocumented immigrants and lawful immigrants who have lived in the U.S. for less than five years are excluded from new coverage opportunities, including state health insurance exchanges and Medicaid expansions.
A recent report by the UC-Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research on California residents who will remain uninsured after the ACA takes effect found that:
- 66% of the remaining uninsured will be Latino;
- 60% of the remaining uninsured will have limited English proficiency; and
- 62% of the remaining uninsured will live in Southern California.
The report also found that about 50% of those still uninsured five years after the ACA takes effect will qualify for coverage under the Medi-Cal expansion or for health benefit exchange subsidies, but they will not be aware that they qualify because of poor outreach. Medi-Cal is California's Medicaid program.
Potential Strategies for Treating Uninsured Immigrants
Chad Silva — policy director for The Latino Coalition for a Healthy California — said he is worried that state officials do not recognize the need for grassroots efforts and resources to communicate with immigrant populations.
He said that the state must form partnerships with community-based organizations to reach such populations, adding that community health educators can help inform Latino communities throughout the state about coverage opportunities.
According to HealthyCal, community clinics can provide for patients who are part of a "mixed citizenship status" family, which includes at least one parent who is an undocumented immigrant.
Sonal Ambegaokar — a health policy attorney at the National Immigration Law Center — said that no one in mixed citizenship families is likely to apply for coverage once they understand that non-citizens cannot obtain coverage under ACA.
John Gressman — president and CEO of the San Francisco Community Clinic Consortium — said that community clinics such as SFCCC can provide care for a newly insured family member, as well as those who remain uninsured.
SFCCC is working on strategies to pay for the care of patients who will remain uninsured. Gressman said that one strategy is to reorganize the way the clinics provide treatment into a team-based care model that would reduce costs and increase efficiency.
SFCCC clinics also are trying to reduce health disparities by giving health care providers culture competency training and increasing the number of Spanish-speaking doctors.
Meanwhile, health care advocates continue to lobby legislators to remove immigration status as a qualification for new coverage under ACA. Ambegaokar said, "The simpler the system, the better the access will be" (Shanafelt, HealthyCal, 10/23).