Demystifying the Costs of Single Payer Healthcare for

Latino Immigrants

Kyla Adams MPH(c), CHES NCLR/CSULB Center for Latino Community Health CaHPSA/CSULB Chapter Co-Chair

Topics to be Discussed

• Background• Limitations of the Affordable Care Act • Myths and Facts:• Healthcare expenditures and Latino immigrants.• Contributions of the immigrant population• Who currently pays for healthcare services to Latino immigrants.

• Why single payer is California’s best fiscal option• Single Payer: a moral responsibility

Background

• 47 million persons in the United States are uninsured• One in three uninsured in the United States are Hispanic• 42% of Latinos lack healthcare compared with 19% of Non-

Hispanic Whites• Hispanic/Latinos make up 15% of the United States population

and they are projected to grow to 30% by 2050• In 2009, an estimated 2,600,000 undocumented immigrants

resided in California

(Pew Hispanic Center, 2008), (McDonald, M., 2008)

Limitations of Affordable Care Act (ACA)

• GAINS: • Six-million Hispanics newly insured• Half of newly insured Latino citizens will benefit from the Medicaid expansion• Increased employer accountability to cover Hispanic employees

• LIMITATIONS:• 25% of the 26 million left uninsured undocumented (Buettgens, 2007)

• Includes low-income up to 133% of FPL who are not:• Age 65 and older • Eligible for Part A or enrolled in Part B Medicare (Blewett, 2010)

• Undocumented are barred from state exchanges-even if purchasing entirely with their own money • Undocumented not eligible for Medicaid or CHIP (Ponce, 2010)

Antonovich, Michael D. L.A. County Supervisor• "The question taxpayers keep asking is 'why should we pay for

services for those who have broken the law to get here?' They should not, nor should they be forced to be the Health Maintenance Organization (HMO) and School District of the world. This is evidenced in every poll I have seen indicating that every ethnic group is opposed to illegal immigration and supports enforcement of the law."

(Prepared remarks Feb., 1994)

Myth: Latino immigrants abuse services(Campaign for SB810, 2010)

• Costs attributable to Hispanics/Latinos are 50% lower than Non-Hispanic Whites (NCLR,2009).

• 30% of immigrants use no healthcare services in course of year (PNHP,2010)

• Multiple barriers to care • Ineligible for many federal programs such as Medicaid and State

Children’s health insurance Program (SCHIP) (NCLR,2007).

• Unauthorized immigrants make up a fraction of the population• Less than one-quarter of the uninsured in the U.S. (CIPC,2006)

Myth: Latino immigrants don’t contribute to economy (Campaign for SB810, 2010)

• Immigrants are a growing part of the workforce• Make up one-third of workforce and contribute roughly one-third of state’s GDP

• Immigrant spending and tax contribution help California economy• Immigrants in California have a combined federal tax contribution of more than

$30 billion annually

• Immigrants are a powerful force in shaping California policy • 25% of Hispanic/Latino immigrants vote in California• Non-citizens make up 20% of the voting-age population in half (32) of California’s

64 cities where the population is 100,000 or more

(Shamsunder, 2012)

Myth: Covering Latino immigrants is too expensive(Campaign for SB810, 2010)

• Taxpayers already cover uncompensated care costs.• If every Californian got preventative care $3.4 billion saved (PNHP,

2010)

• 75% of uncompensated care costs in the U.S. are covered by the government (Hadley, 2003) (Goldman, 2006)

• Currently, many Hispanic/Latino immigrants pay for their own healthcare services out of pocket• 25% Hispanics take from savings to pay for healthcare (Ng’andu, 2007)

Sources of funding for uncompensated care in billions (2008)

*Taxpayers finance $30 billion for Medicare and Medicaid uncompensated care costs

(Holohan, 2010)

Estimated changes in spending on uncompensated care under Comprehensive reform

(Holohan, 2010)

How will Single Payer finance Healthcare for immigrants?

Sources of Funding

Medicare and Medicaid would

be Retained

(7%) Payroll tax on employers

(2%) income tax on individuals

• Eliminate private insurance and recapture administrative waste

• Savings of 16% annually • Healthier/more productive

employees

• Net payments for healthcare would decrease

• No co-pays, deductibles, or premiums

Single Payer: Benefits California and United States Economy

• The Lewin Group Report, 2005, affirms that we can create a fiscally sound and comprehensive insurance plan with the following savings:• State and local governments would save $900 million in the first

year• Save the nation $150 million per year• Aggregate savings from 2006-2012 would be about $43.8 billion • Average family spending for healthcare would be expected to

decline over $2,000• An estimated $317 billion in increased business and public

revenues throughout the US economy

(Kuehl, 2005)

Single Payer: a moral responsibility

• Declaration of Human Rights Article 25

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control”

Conclusion • We are currently financing healthcare for Latino immigrants-

including the undocumented• The Latino immigrant population make considerable

contributions to California economy, state GDP, and public policies

• Single Payer is a comprehensive system that covers everyone and brings costs DOWN

• Economically, politically, and morally single payer is the obvious choice

• Everybody in, NOBODY OUT!!!

References

Blewett, L.. (2010). Left Behind: undocumented immigrants under the affordable care act. State Health Access Data Assistance Center. Buettgens, M., Hall, A., M. (2011). Who will be uninsured after health insurance reform. Robert Wood Johnson Foundation

California Immigrant Policy Center. (2006). Immigrants and the U.S. healthcare system. Retrieved from: www.caimmigrant.org

Campaign for SB 810-Single Payer Universal Healthcare. (2010). Myths about SB 810 and Responses. California One Care.

Goldman, D., Smith, J., & Sood, N. (2006). Immigrants and the cost of medical care. Health Affairs 25(6). 1700-1711. Hadley, J. (2003). Economic consequences of being uninsured: uncompensated care, inefficient medical care spending, and foregone earnings. Testimony to the senate subcommittee on labor and Health and Human Services.

Holohan, J., & Garret, B. (2010). The cost of uncompensated care with and without healthcare reform: timely analysis of immediate health policy issues. The Urban Institute. 1-4.

Keuhl, S. (2005). Lewin group report. The Health Care for All Californians Act: Cost and Economic Impacts Analysis. Factsheet. Retrieved From: http://www.pnhp.org/news/2005/january/lewin_group_analysis.php

McDonald, M., Hertz, R.(2008). Pfizer facts: a profile of the uninsured persons in the United States. Pfizer medical division. 1-87.

National Council of La Raza. (2009). Profiles of Latino health: The top twelve questions about Latinos and healthcare. Factsheet: Question 9.

NCLR calculation using U.S. Census Bureau. (2011) Current population survey (CPS) table creator. Annual Social and Economic Supplement. Retrieved From: http://www.census.gov/hhes/www/cpstc/cps_table_creator.html

Physicians for a National Health Program. (2010). Why we need SB 810, The California universal healthcare act. Retrieved From: www.pnhp.org

The Rockefeller Foundation. (2008). American Worker Survey: Complete Results. Retrieved from: http://www.rockfound.org/initiatives/amer_workers/american_worker_survey.pdf

Ponce, N., Lavareeda, S., & Cabezas, L. (2011). The impact of healthcare reform on California’s children in immigrant families. Health Policy Brief. UCLA Center for Health Policy Research.

Shamasunder, R., and Alegria, I. (2012). Looking foroward: immigrant contributions to the golden state. California Immigrant Policy Center. Retrieved from: http://www.clca.us/immigration/moreinfoDocs/ALLCAPages.pdf

Contact Information

Kyla R. Adams MPH (c), CHESNCLR/Center for Latino and Community Health

CaHPSA/CSULB Chapter Co-Chair 6300 State University Drive

Suite 125 Long Beach, CA 90814adamskyla@yahoo.com