Implementing health reform: Maximizing health care equity for Latino families

Since passage of health care reform legislation last year, experts at the national, state, and local levels have been preparing for the enormous task of implementing the law. Many health disparities populations stood among the most to gain from health reform—including Latinos, the largest and fastest-growing racial/ethnic group in the U.S—for they are disproportionately affected by long-standing barriers to health coverage and care. However, Latinos are among the most vulnerable to falling through the cracks in the new system; the law imposes unprecedented restrictions on immigrants' access to coverage that are also likely to complicate enrollment for those eligible. To address these issues, the National Council of La Raza (NCLR) conducted 11 focus groups with Hispanic adults in six U.S. cities—Miami, Denver, Charlotte, Chicago, Portland and Fairfax, VA. Approximately half of participants were noncitizens, including both legal and undocumented immigrants, and half were U.S. citizens. Many were noncitizen parents of U.S.-citizen children (“mixed-status families”). The detailed findings provide a nuanced understanding of factors that can either promote or impede access to health care for Latino families, and inform NCLR's concrete recommendations to facilitate Latinos' access to new health plans and explore alternative pathways to health care services for those who are unable to obtain health insurance. These findings can help policymakers and administrators make implementation decisions that maximize opportunities both to enroll eligible Hispanics in health coverage and also to ensure that Latinos and others left uninsured are not shut out of the health care system altogether.