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California Immigrants to Gain from Health Care Law

Posted: Jun 29, 2012

Editor’s Note: Since she joined The San Francisco Foundation 30 years ago, Chief Executive Officer Dr. Sandra Hernandez has been promoting her foundation’s efforts to help low-income communities in and around San Francisco gain access to health care and other services. As a practicing physician at San Francisco General Hospital, she has seen first hand the value of health care.

Hernandez sat down with New America Media health editor, Viji Sundaram, to talk about how the health care reform law will especially benefit California’s Hispanic population. Of the 6.9 million Californians currently uninsured, 60 percent are Latinos.

NAM: You are clearly exuberant over today’s Supreme Court decision to leave the Affordable Care Act largely intact. California had a huge stake in the outcome, given it has a large number of undocumented, uninsured and underinsured people, many of them Latinos.

Hernandez: Close to two million Latinos in California will be covered under the Affordable Care Act either through Medi-Cal expansion or through the Health Exchange. It’s really the most important [sector] for a couple of reasons -- because that’s the population that’s going to pay the most out-of-pocket for health services, medications and other services, and also because it’s the largest uninsured population that we have in California.

NAM: But what about the rest of the Latino population?

Hernandez: The ACA does not cover all Latinos, nor does it cover all Californians. There are close to 2 million Californians who do not have documents. The ACA will not subsidize their care and they are not eligible for benefits under Medi-Cal expansion or the Health Care Exchange. However, the one thing that the ACA does do is to create the infrastructure in the primary care clinics that historically serve this population with culturally and linguistically competent care.

NAM: Are you referring to the community health care clinics?

Hernandez: Yes. Those clinics are vital, absolutely vital to both the implementation of the ACA and also in making sure that we leave nobody behind as we implement the ACA.

ACA is also important for California because it will require that we invest a lot of educational resources to be able to grow the health care delivery infrastructure of people - we are going to need more primary care physicians; we’re going to need more pediatricians; we’re going to need more nurses; we’re going to need more promotoras. We’re going to need to be able to expand the health care professions adequately to serve populations that have historically only used services when they absolutely had to at very high cost emergency rooms.

NAM: How else will the immigrant populations benefit from the law?

Hernandez: One of the things the ACA does is to offer prevention services that do not require a co-pay. A lot of health care foundations have developed bilingual outreach and education programs to get the word out that we want people to get care early, to take advantage of the prevention clause.

(Preventive care) is something immigrant communities have historically done very well. If you look at the data, immigrants often come here with a sense of wellness practices. One of the things we need to do is to support those preventive initiatives that have kept immigrant communities well even though they’ve been outside the insurance system.

NAM: Not everyone takes advantage of the health care programs available to them. Why do you think this is?

Hernandez: There are many, many, many families today who are eligible for programs. They don’t take advantage of them because the eligibility is cumbersome, or complicated, or you don’t know what paper work you are going to be asked for. (Some of these barriers) will be removed with the implementation of the ACA.

NAM: How do you feel about the fact that the undocumented will not be able to benefit from the ACA?

Hernandez: It’s very unfortunate. If you look at the principle of the law, it was shared responsibility. And the best way to improve the cost and outcome in the system is to have everybody in the system.

But the fact that there will be a very large influx of federal dollars to expand coverage for those who are eligible for Medi-Cal or for the Health Care Exchange will benefit our entire infrastructure of delivery. For instance, the core principle for Healthy San Francisco, which covers even the undocumented, is you cannot be eligible for any other federal program to be in it.

So in 2014, when the federal programs expand, many people who are currently in Healthy San Francisco will leave it to enroll in other programs, leaving more dollars to serve the undocumented and legitimate community needs. 44900681

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