9 Critical Questions on Medicaid and the Latino Healthcare Crisis

Latinos are uninsured more than two times the rate of their white peers.

Given that Latinos are projected to grow to 29% of the population by 2050, this lack of healthcare coverage, including Medicaid, will continue to endanger the health of many more individuals, families, and the healthcare system.

In honor of Minority Health Month, we’re raising awareness of the Latino healthcare crisis, its impact on Latino communities, and how you can help Latinos gain health insurance coverage.

How Many Latinos Lack Health Insurance?

Despite the benefits of health insurance, people of color, low-income families, and other vulnerable groups unfortunately lack health insurance coverage in the US.

Latinos are especially uninsured.

A 2022 Census Bureau report found that Latinos had the highest uninsured rate in the nation at 17.7%.

The lack of health insurance coverage extends to young Latinos, too.

More than 1.8 million US Latino children do not have health insurance. The share of all children without health insurance has risen since 2016, but the increase has been most pronounced for Latino children.

Why are Latinos More Uninsured Than Other Groups?

The cost of healthcare and medical services is a significant barrier for the Latino community.

Latinos are less likely to obtain private health insurance from their employers — which is the most common source of health coverage in the US.

Industries where Latinos commonly work that are less likely to offer private health insurance include:

health insurance

However, even if health insurance is offered through an employer, some Latinos still cannot afford their share of coverage costs.

In 2020, only 49.9% of Latinos had private insurance, far less than white Americans (73.9%).

“Latinos are caught in a vicious cycle when it comes to healthcare,” Geoffrey Nagle writes in a Forbes article. “Low or no access to quality healthcare leads to poor health, which makes healthcare more expensive and even less accessible to underserved communities.”

Other significant barriers to health insurance include discrimination and physician implicit bias, or subconscious preferences for white patients over those of color. The cost of coverage and the potential discrimination Latinos face in doctors’ offices may make them feel that health insurance isn’t worth the investment.

Language is another big issue. Spanish is the most-spoken non-English language in the US, and those with limited English proficiency may be underusing healthcare assets that they need, according to a 2021 study in Health Affairs.

“[Spending on healthcare was] $1,463 (35%) lower for Hispanic adults with limited English proficiency than for Hispanic adults who were English proficient,” according to the study. “These language-based gaps in spending and use raise concern that language barriers may be obstructing access to care, resulting in underuse of medical services by adults with limited English proficiency.”

Risks in enrolling in healthcare coverage are another concern.

For immigrants who aren’t US citizens, they may fear their immigration status will be revealed or held against them upon enrolling in coverage.

What is Medicaid and the Affordable Care Act (ACA)?

Latino health insurance coverage

Fortunately, uninsured rates in the Latino population fell from 30% in 2013 to a low of 19% in 2017 due to the passage of the ACA.

The ACA, sometimes referred to as Obamacare, is a comprehensive healthcare reform law enacted in March 2010 that made health insurance more affordable for more people.

Under the ACA, eligible Latinos who cannot obtain private health insurance through employers, can more easily afford public health insurance, such as through the public marketplace and Medicaid.

Medicaid is health insurance for eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

What is the State of Medicaid and Latinos?

Perhaps one of the biggest benefits of the ACA for low-income households are Medicaid expansions, which broaden eligibility requirements to enroll in the program, giving more people access to affordable healthcare.

For example, Oklahoma (11.7% Latino), the state with the second-highest uninsured rate after Texas, voted to expand Medicaid on July 1, 2020. A month later on August 4, Missouri (4.7% Latino) also voted to expand Medicaid. In Oklahoma alone, roughly 200,000 low-income adults became eligible for Medicaid after the program’s expansion.

However, not all states have adopted Medicaid expansions, including Texas (40.2% Latino), the state with the highest uninsured rate.

As of March 2023, 10 US states continue to reject Medicaid expansion, leaving many without an affordable healthcare coverage option.

Why Are Some Latinos Stuck in a Coverage Gap?

unaffordable health insurance

Medicaid expansions have benefitted millions in the nation.

But even with these expansions, some Latinos who can’t obtain private insurance through an employer are stuck in a coverage gap – meaning they don’t qualify for Medicaid, but still struggle to afford healthcare coverage in the public marketplace.

In fact, over 2.2 million adults nationwide are in the Medicaid coverage gap, according to the Center on Budget and Policy Priorities.

The coverage gap is more apparent in states where Medicaid has not been expanded, such as Texas. Some 766,000 uninsured adults, 55% of which are Latino, would become eligible if Texas expanded Medicaid.

How Does a Lack of Health Insurance Impact the Latino Community?

The rate of uninsured Latinos is extremely high compared to other racial/ethnic groups.

In 2020, 18.3% of the Latino population was not covered by health insurance, compared to 5.4% of white non-Latinos, according to a 2021 Census Bureau report.

A lack of health insurance coverage can harm health.

“Going without coverage can have serious health consequences for the uninsured because they receive less preventive care; and delayed care often results in serious illness or other health problems,” according to the Kaiser Family Foundation. “The financial consequences of not having insurance [can also lead] to difficulties paying medical bills and higher rates of medical debt among the uninsured.”

COVID-19 also did no favors for uninsured Latinos.

The pandemic made things worse for Latinos in healthcare access, according to Kimberly Miller, a scientist with the American Cancer Society.

“We know that the Hispanic community was hit harder by the pandemic than many other racial and ethnic groups,” Miller told US News & World Report. “Many lost employment and health insurance, and were afraid to go to the doctor and get recommended cancer screenings.”

How Can Leaders Help Latinos Get the Coverage They Need?

Though many Latinos have gained coverage under the ACA, a significant disparity in uninsured rates between Latinos and non-Latinos persists, particularly in states that have not adopted Medicaid expansions.

The 2021 report by the Office of Health Policy provides numerous ways to improve coverage and access to care among Latinos, including:

getting health insurance

  • Increasing funding for enrollment outreach
  • Providing online navigator assistance
  • Improving education about coverage options

Many groups are already working hard to connect Latinos to healthcare coverage.

For example, Raising Women’s Voices developed a Spanish guide to help Latinas utilize health insurance resources. The guide, Mi Salud, Mi Voz: Una Guía Paso a Paso Para Mujeres Sobre Cómo Usar el Seguro Médico, explains how to use insurance cards and choose a primary care provider who is in a health plan network.

Rocio Muñoz, a health navigator for Benton County Health Department, worked with the local school district in Corvallis, Oregon (14% Latino) to connect families to health insurance, health care services, and well child checks.

How Can I Help Latinos Gain Healthcare Access?

You can play a role in advocating for systemic change.

Select your county name and get a Health Equity Report Card by Salud America!

You can see how your area compares to the rest of your state and nation in access to healthcare, housing, transit, and other health equity issues.

You can email your Health Equity Report Card to local leaders or share it on social media. Use it to make a case for community change to boost health equity.

Get your Health Equity Report Card!

How Can I Get Health Insurance Coverage?

If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can apply for those programs anytime.

Open enrollment for public marketplace coverage is over for 2023, but you can still get coverage if you qualify for a special enrollment period due to a life event, like having a baby or getting married.

Get more information on open enrollment in English or Spanish.

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