TOWARD A NEW HORIZON:
THE REMAINING UNINSURED
& PROSPECTS FOR
COVERAGE AND CARE
January 23, 2014
Overview
• How does the ACA impact minority
communities?
• Who is likely to remain uninsured?
• What are key barriers to insurance?
• What are potential pathways for coverage
and care?
Impact on Minority
Communities
• Projected to increase health insurance to 32
million individuals
• 6.8 million African-Americans eligible for
Marketplace coverage
• 10.2 million Latinos eligible for Marketplace
coverage
• Investments in prevention to address chronic
disease
The Remaining Uninsured
ACA ≠ universal coverage
• 26 million estimated to remain
uninsured
– Eligible and uninsured
– Ineligible and uninsured
• Informal and structural barriers
The Remaining Uninsured
The Remaining Uninsured
Medicaid Expansion
• Key coverage vehicle in ACA
• 2012 Supreme Court decision
– 26 expansion states; 25 non-expansion
• 5 million in “coverage gap”
– disproportionate effect on minorities
• 2.6 million (53%)
– South acutely affected
• TX, FL
Select Barriers to Insurance
Immigration
Status
Language
Access
Affordability
Potential Pathways for
Coverage and Care
State and Local Pathways
Washington Apple Health for Kids
• Health insurance for children up to 300%
FPL
• Eligibility depends on income, eligibility for
other programs, but not immigration status
• Comprehensive benefits
• Over 500,000 currently enrolled
State and Local Pathways
CareLink
• Financial assistance program
• Eligibility depends on income, eligibility for
other programs, and Bexar County
residency
• Members assigned PCP and medical
home
• Benefits include preventive care, mental
health, and prescriptions
Alternative Pathways
Restaurant Opportunities Center United’s
MD-Program
• Health care cooperative
• Pilot program launched in 2011 in Los
Angeles
• Eligibility does not depend on income or
immigration status
• $20 premium and $5 ROC-LA membership
Alternative Pathways
Access to Healthcare Network (AHN)
• Coordinated network of providers
• Shared responsibility model
• Focuses on health care needs of those
between100%-250% FPL
• Caters to those either statutorily ineligible
or have legal opt-out of individual mandate
Alternative Pathways
Binational or Cross Border Insurance
• Insurance products targeted to uninsured
Mexican-born population living in the
United States
• Sistems Medicos Nacionales, Salud con
Health Net and Salud Mexico, Blue Shield
Access Baja
• Mexican Social Security Institute (IMMS),
Seguro Popular
• CA only demonstration site
Steven Lopez
Senior Health Policy Analyst
National Council of La Raza
slopez@nclr.org
202-776-1809
www.nclr.org/healthcareforall