Compared with other Americans, Latinos are less likely to receive preventive care and more likely to have chronic diseases such as diabetes, cancer, and HIV/AIDS.12,13 The Affordable Care Act helps to make prevention affordable and accessible by requiring most health insurance plans to cover prevention and wellness benefits with no cost-sharing.14 The services that these insurers are now required to cover with no cost-sharing include well-child visits, blood pressure and cholesterol screenings, Pap smears and mammograms for women, and flu shots for both children and adults. Pap smears are particularly important for Latino women, who contract cervical cancer at twice the rate of their non-Latino White counterparts.15 The law requires insurers to cover HIV screening without cost-sharing for individuals at high risk of infection. This is important for Hispanics/Latinos, who represent 20 percent of the total estimated number of HIV diagnoses among adults and adolescents.16 An estimated 6.1 million Latino Americans with private insurance currently have access to expanded preventive services with no cost-sharing because of the Affordable Care Act.17
The 3.9 million elderly and disabled Latinos who receive health coverage from Medicare also have access to an expanded list of preventive services with no cost-sharing under the Affordable Care Act. These benefits include an annual wellness visit with a personalized prevention plan, and access to such important screenings as colorectal cancer and obesity screening, bone mass measurement, and mammograms.18
The Affordable Care Act benefits Latinos in many other ways, including:
- Improving Chronic Disease Management. Racial and ethnic minorities often receive lower quality care and face more barriers in accessing care and chronic disease management than non-Latino Whites.19 Latinos report poorer quality of care and lower access to care than non-Latino Whites for approximately 60 percent of core quality measures and 83 percent of core access measures, including availability of cancer screenings and recommended treatments for diabetes.20,21 When chronic conditions are not properly managed, patients often acquire secondary conditions and experience poorer health outcomes. For example, Latinos with diabetes are more likely to incur kidney disease and foot amputations than their non-Latino White counterparts.22 The Affordable Care Act’s Innovation Center explores opportunities to invest in care innovations such as community health teams to improve the management of chronic disease.23 Such investments seek to improve care for Latinos suffering from chronic disease such as the estimated 4.3 million Latino adults with diabetes.24
- Increasing Access to Community Health Centers. Approximately 35 percent of patients served by community health centers in 2009 were Latino. The Affordable Care Act increases the funding available to the more than 1,100 community health centers—located in all fifty states, the District of Columbia, and Puerto Rico—to enable them to increase the number of patients they serve. Health centers have received funding to create new health center sites in medically underserved areas, to expand preventive and primary health care services, and to support major construction and renovation projects.25
- Diversifying the Health Care Workforce and Strengthening its Cultural Competency. The Affordable Care Act increases the racial and ethnic diversity of doctors, nurses, and other health care professionals. For example, the law has helped to nearly triple the number of clinicians in the National Health Service Corps, a network of primary care providers serving communities with significant medical, dental, or mental/behavioral health needs. 26 The Corps provides scholarships and loan repayment to medical students and primary care physicians, as well as other health professionals, in exchange for a commitment to serve in an underserved area. Latino physicians make up about 20.8 percent of the Corps, a percentage that greatly exceeds their 5.5 percent share of the national physician workforce.27
Other initiatives in the Affordable Care Act make it easier for people with disadvantaged backgrounds to become health care professionals and strengthen cultural competency training among health care providers.28 These initiatives will help providers to better address the needs of Latinos and other minorities and communicate more effectively with their patients.
- Addressing Health Disparities. The Affordable Care Act invests in data collection and research focused on disparities in health and health care to help us better understand the causes of healthcare disparities and develop effective programs to eliminate them.29 The law requires the Secretary of the U.S. Department of Health and Human Services (HHS) to establish data collection standards for race, ethnicity, sex, primary language, and disability status for inclusion in surveys conducted or sponsored by HHS. In 2011, HHS released ethnicity standards for data collection and has begun the process of upgrading data collection standards in the other areas. The ethnicity standards expand the response categories on HHS population surveys to Hispanic, Latino(a) or Spanish origin, include questions on specific origins (for example, Mexican, Puerto Rican, and Cuban), and will be asked of survey participants of all ages. This upgrade in data collection standards will help illuminate health disparities among this diverse ethnic group and gauge progress made towards eliminating these disparities.30 Leveraging the Affordable Care Act, HHS has also developed and is implementing the HHS Disparities Action Plan, the Department’s largest commitment to disparities elimination to date.31
The Affordable Care Act also invests in the Community Transformation Grant program to support states and communities by promoting healthy lifestyles (for example, tobacco-free living), especially among groups experiencing high rates of chronic disease such as Latinos. The program aims to improve health, reduce health disparities, and lower health care costs.32 The law promotes the National Center on Minority Health and Health Disparities at the National Institutes of Health (NIH) to Institute status, enabling it to access increased funding and to plan, coordinate, and evaluate disparity-related research within NIH.33 The law also creates a Patient-Centered Outcomes Research Institute which funds research that helps patients and their care providers make more informed treatment decisions, including the study of differences in healthcare outcomes among racial and ethnic minorities.34
- Puerto Rico. An estimated 23 percent of Puerto Rico residents are enrolled in Medicaid, but federal Medicaid funding for the Commonwealth, unlike that for the 50 states and the District of Columbia, is subject to a statutory cap. The Affordable Care Act provides additional funding to raise this cap and also increases the Federal Medical Assistance Percentage (FMAP) for Puerto Rico from 50 to 55 percent.35 The Affordable Care Act also allocates $925 million for subsidies to Puerto Rico residents who participate in the Commonwealth’s Affordable Insurance Exchange.36
Because of the Affordable Care Act, all Americans will have access to affordable health care coverage. For Latinos, the benefits are especially important. The law’s benefits will help reduce disparities in both health care and health outcomes through expanded insurance coverage and better access to high-quality health care services.
Key Benefits of the Affordable Care Act for Latinos
Key Benefits of the Affordable Care Act for Latinos
|Benefit||Number of Latinos Affected||When Effective|
|Expanded Insurance Coverage (ages 19-25)||736,000||Plan years beginning on or after September 23, 2010|
|Preventive Health Services (Private Insurance)||6,100,000||Plan years beginning on or after September 23, 2010|
|Preventive Health Services (Medicare)||3,900,000||January 1, 2011|
|Expanded Insurance Coverage (ages 0-64)||5,400,00||January 1, 2014|
More than Five Million Latinos Will Gain Coverage Under the Affordable Care Act
Source: RAND COMPARE microsimulation model.
Note: Estimates shown are for 2016 coverage of individuals ages 0-64 identifying themselves as Spanish, Hispanic, or Latino.