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Health Care Reform

What the new law means to Hispanics.

Elizabeth Campos was among the millions of Americans who uttered a sigh of relief when health care reform became law in March. “I kept track of health care reform,” she says, “but I wondered, ‘Will things change in time for me?’ ”

The answer is yes. The health care law will provide immediate benefits for many Latinos, including Campos, and by the time it is fully implemented, health advocates predict that millions of previously uninsured Hispanics will benefit.

For Campos, 62, at least one of the law’s provisions could be a lifesaver. A former hospital admissions clerk who lives in Manhattan, Campos was diagnosed with cancer in 1994, followed by other illnesses that forced her to quit work. She paid for her expensive medications with insurance through her union, but this year, facing her policy’s lifetime cap of $500,000, she began rationing her medicines. Now she will no longer have to do that because the new law will eliminate lifetime and “unreasonable” caps on insurance benefits.

Also set to take effect this year are high-risk insurance pools to cover people with preexisting conditions who have had no insurance for six months—like Eileen Currás, 48, of Orlando. She suffers from multiple sclerosis and is uninsured. The temporary insurance pools will provide help for Currás, and others in this situation, until 2014, when the new law will prohibit private insurers from denying coverage for preexisting conditions.

Some of the new law’s other provisions will take longer to implement. As Josephine Mercado, of Hispanic Health Initiatives, a nonprofit organization in Florida, says, “It's not going to create miracles overnight.”

Jorge Alonso and Jeanne Morales, a married couple who fall into the 50-to-64 age group and who own an advertising firm in Los Angeles, flinch every time they pay their personal monthly health insurance bill, a whopping $1,665. As small business owners, they could be eligible to receive a tax credit this year for starting a group employee insurance plan. But because their current policies are individual, they will have to wait until 2014, when the new insurance exchanges will go into effect, offering them less-expensive options to choose from.

Also starting in 2014, all uninsured Americans whose income is less than 133 percent of poverty level will receive Medicaid, and those who earn 133 to 400 percent of poverty level ($14,403 to $43,320 for individuals; $29,326 to $88,200 for families of four) will be eligible for subsidies and tax credits. Advocates say that eventually an estimated 60 percent of currently uninsured Latinos (8.8 million) will be covered. Among them could be Juanita and Manuel Gutiérrez of Fremont, Ohio. Two years ago, they were priced out of the insurance market when Manuel, 57, a truck driver, switched companies. “We’re not asking for handouts,” says Juanita, 50. “All we ask for is health insurance that we can afford.”

As Congress struggled to pass reform, some provisions that would have aided Latinos were jettisoned. Pleas by Hispanic advocates to end the five-year waiting period for legal permanent residents to enroll in Medicaid or Medicare went unheeded and were ultimately rejected. (Other categories of legal foreign nationals may never qualify for Medicaid and Medicare.) And undocumented immigrants won't be able to buy policies in the insurance exchanges—even with their own money—and won’t benefit from subsidies or the expansion of Medicaid.

That leaves Alicia Wilson, who is the executive director of La Clínica del Pueblo in Washington, D.C., disappointed. But she’s glad the law allocates $11 billion to expand the network of health centers that serve low-income Latinos and undocumented immigrants. “We’re hoping this will help us grow and see more patients,” she says.

That's good news for Azucena Carrillo, 44, a housekeeper. Born in Nicaragua and now a U.S. citizen, she has lived in this country 22 years, but during that time has had insurance for just a few months. That was when she was covered under her husband Roberto’s plan at work. But last year, Roberto, 48, lost his job at a mattress factory and the Maryland couple can’t afford private insurance. They rely on a community clinic. “The clinic takes good care of us. We were worried about the future,” Azucena Carrillo says.
Another win: Under a last-minute deal, Puerto Rico will be able to establish its own insurance exchange, though total subsidies to those who want to buy insurance in that exchange would be capped at $925 million. The island also will receive the lion’s share of a $1 billion payout to U.S. territories to help with struggling Medicaid programs. In Puerto Rico, Medicaid is folded into a larger health care system for the poor that serves more than three million residents. Yet as many as 500,000 are uninsured because they earn too much to qualify for the government plan and too little to afford private insurance.

Rolance G. Chavier Roper, M.D., president of the Puerto Rico Medical Association, says the new law will help many uninsured, even though islanders continue to enjoy fewer health benefits—especially under Medicare—than other Americans. “It’s never enough,” he says, “but it’s much better than what we have.”

Overall, despite the law’s limitations, Elena Rios, M.D., president and CEO of the National Hispanic Medical Association, believes it will revolutionize the way we think about medical care in the United States. As she puts it, “Now, for the first time, health care is a right.”

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