Q&A: Closing the Health Coverage Gap for Hispanic Children

Q&A: Closing the Health Coverage Gap for Hispanic Children

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Ed. Note: A new study out this week finds that over 11 percent of Hispanic children are uninsured, compared to 7.1 percent of all kids nationwide. Study author Sonya Schwartz is a research fellow with the Georgetown University Health Policy Institute’s Center for Children and Families, which released the study along with the National Council of La Raza. She spoke with NAM about why Hispanic children are still disproportionately uninsured and what could close the coverage gap in states that are lagging behind.

What’s the current state of health coverage for Hispanic children nationwide?

We’re making solid progress. Since 2009, the number of Hispanic children who are uninsured has dropped by more than half a million, while at the same time the total number of Hispanic kids grew by more than a million … Even though we've got a growing number of kids, we're still cutting the uninsured rate over time. Some of the factors contributing to that progress are that we have programs like Medicaid and CHIP [the Children’s Health Insurance Program] that have been available, and that over time state and local areas are doing a better job at getting the word out that kids are eligible.

[But] Hispanic kids remain 1.5 times as likely to be uninsured as all kids … We're talking about 2 million uninsured Hispanic kids. It's estimated by the Urban Institute that two-thirds of these 2 million kids are already eligible for Medicaid and CHIP. The vast majority of these families need to apply for coverage for these kids, because they're most likely going to be eligible for these programs.

Why are Hispanic children still disproportionately uninsured?

First of all, immigration status shouldn't be a major barrier to getting these kids covered. The vast majority of Hispanic kids are U.S. citizens -- 93 percent. Sometimes what happens is they live in families where the parents aren't citizens, or the parents are nervous about applying for programs for their kids even though their kids are eligible …

A second factor that's important is not only providing Spanish outreach to families, but also providing enrollment assistance in places that are safe and trusted by Hispanic families. New York has done a really great job with that. It has one of the most comprehensive community-based enrollment programs in the country.

What states are doing a good job at insuring Hispanic children?

Washington DC is actually the best place for Hispanic kids' coverage. The rate of uninsurance for Hispanic kids in DC is below 1 percent, and about 15 percent of all kids are Hispanic there. DC rarely gets credit for anything, but it’s covered all kids up to 300 percent of the federal poverty level, it's covered kids regardless of immigration status … And it's not just the kids' coverage, it's the adult coverage, the parent coverage. DC has had a program for a long time now that's called the DC Healthcare Alliance, and that program was almost like an early Medicaid expansion for DC. It covers adults up to 200 percent of the federal poverty level, and it covers them regardless of their immigration status.

In California, there was an early Medicaid expansion for adults, and with more parents being insured, that may have brought some kids on board. You also have a history of programs at the county level that cover all kids and have a lot of outreach and enrollment funding and resources.

What’s going on in a state like Texas, which has one of the largest uninsured Hispanic child populations, and 17 percent of them uninsured?

Texas has the most uninsured Hispanic kids in the country … Two things would really help Texas. One is expanding Medicaid to low-income adults, because that would cover parents, and as they came into coverage, hopefully they'd bring their kids along with them. The second thing is [the renewal of CHIP funding] -- Texas really needs CHIP, because it doesn't have its own local program. That program runs out of money in September 2015 if Congress does not extend funding for it. So Texas needs to be pushing for that to happen.

With the GOP in control of Congress, do you see any threats to children’s coverage programs?

I think everyone in Congress will remember that CHIP was a bipartisan program when it passed, when it became law ... We had plenty of Republicans who were really supportive at the time. It's a program for working families and we're hoping that it will stay in place. It's a cost-effective program and it shows incredible results.

What about the prospects for Medicaid expansion in states like Texas?


Reasonable Republican governors have expanded Medicaid … It doesn't have to be a Democratic issue. Sensible governors will realize that this is in the best interest of their states financially and for the sake of families. This wasn't an easy election for Medicaid expansion. Our hopes are not as high as they might have been.

What do families need to know?

Families need to know that it's safe to apply for coverage for children … and that even if they've been turned down before when they tried to apply for health coverage for their kids, it's time to try again … Families can call 1-877-KIDS-NOW, and assistance is available in Spanish.
 

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