October 26, 2016
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Reform Could Bridge Ethnic Health Care Gap

 By Poornima Weerasekara, New America Media



 In California, where 70 percent of those without health insurance are people of color, the new health care law could help reduce ethnic health disparities. 

But speakers at the recent Ethnic Physician Leadership Summit in Los Angeles stressed their concerns because many details for implementing the new law, called the Patient Protection and Affordable Care Act (ACA), are yet to be finalized.

“If you look at previous health care reforms, including Medicare in the ’60s and the recent Medicare Part D [prescription-drug program], passed by the Bush administration, the laws included many implementation details,” said Anmol S. Mahal, MD, Past President of the California Medical Association (CMA). 

“But the current law leaves room for the Department of Health and Human Services and a federal commission to draft [regulations]. We are still not sure how these implementation details would affect physicians.” 

Panelists at the summit noted that a significant portion of ethnic communities find it challenging to utilize the existing health care system because they are either uninsured or under-insured. 

“There are several studies specially focusing on the African American community, which show that even if you control for economic and environmental factors, there are serious disparities in access to health care,” said Elizabeth McNeil, CMA’s vice president for federal government relations.

For example, nearly six in 10 African Americans felt discriminated against when accessing health facilities, according to a 2003 study by the UCLA Center for Health Policy Research. The survey found that more than one third of Native Americans experienced lower quality health services.

The UCLA research revealed that 30 percent of Asians and 31 percent of Latinos also felt the sting of discrimination when accessing health facilities, McNeil said. She noted that the ACA aims to broaden the health insurance safety net, which would help reduce disparities.

The health care expansion will help more than a million legal Latino immigrants in California, who are currently uninsured, said José A. Arévalo, MD, senior medical director of Sutter Independent Physicians. 

“This is a critical lifeline for the Latino community, since more than half of California's uninsured are Latino,” said Arévalo. He heads the public policy committee of the Network of Ethnic Physician Organizations (NEPO), a coalition of over 40 associations, and the California Medical Association Foundation, which organized the summit.

Arévalo added that providing prenatal care and emergency Medi-Cal services, irrespective of immigrant status, would help curb the high rate of infant and maternal mortality among immigrants. 

The new law, he continued, allows young adults in college to stay on their family’s health care plan for two more years than before, until age 26, Arévalo said. “This will help one in three Latino youth who went without health insurance as of 2007.”

This same provision would allow one in four Asian and Pacific Islander youth, who went without health insurance in 2007, to have health insurance, according to Ellen Wu, executive director of California Pan-Ethnic Health Network.

Provisions in the ACA help 60 percent of uninsured, legal Asian and Pacific Islander immigrants to get coverage, Wu added.

ACA will also bring California $1.4 billion dollars to support its community health centers, which many ethnic communities access.

Another benefit of ACA for all ethnic communities are the public health insurance exchanges that will provide more affordable private coverage, according to Satinder Swaroop, MD, who chairs NEPO. This week California became the first state to pass legislation necessary to create such an insurance exchange.

“Starting in 2014, if you make less than $43,400 as a single adult or $88,200 for a family of four, you will be able to buy affordable coverage from an insurance exchange,” Swaroop said. “Your premium will cost no more than 10 percent of your income--the government will cover the rest.” 

He emphasized, “Citizens or lawfully present immigrant children of undocumented parents can get coverage through this exchange.”


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