The following report explains how Hispanic families, mainly the children, are affected by being uninsured and how the Patient Protection and Affordable Health Care Act will affect them. The Hispanic population has consistently grown in the United States for the past several decades. With the unexpected rapid growth of the minority, several issues have risen including Hispanic families and children being uninsured or underinsured for healthcare. Statistics show millions of children are underinsured, an alarming 31 percent of those being Hispanic (Flores, Olson, Tomany-Korman, 2004). To correct the problem, along with many other concerns, President Obama signed the Patient Protection and Affordable Care Act of 2010. The law was put into place to correct the health care system that the United States previously had. It is a health care reform that requires every individual to carry some form of insurance by 2014. The policy will also require insurance companies to cover individuals with pre-existing conditions. While portions of the Patient Protection and Affordable Care Act have already been put into place, many Americans oppose the idea of the government controlling the healthcare system. Those opposed feel that several problems will arise, and in the beginning, more than likely hitches in the policy will occur. This report will provide a list of potential problems, as well as problems that are currently occurring with Hispanic children without health insurance. The report will entail why individuals without insurance pose a risk to themselves, their families, and taxpayers. Some of the potential problems with the Patient Protection and Affordable Care Act will include: negative effects on poverty stricken Hispanic families who do not utilize the resources available, to question if the fine for not having health insurance is enough to convince the Hispanic families to apply for government programs that are not utilized, and whether or not the act will make a difference with racial discrimination by physicians.
Next, the report will analyze three alternative solutions and policies to the Patient Protection and Affordable Health Care Act. The alternatives include information that would benefit all Americans, but focusing mainly on minorities, such as the poverty stricken Hispanic families that struggle to find affordable healthcare. The three alternative policies are: implicating a new universal healthcare system that is funded by taxed products that cause harmful effects to American citizens, mirroring Canada’s universal healthcare system, and legalizing medical marijuana which would be taxed to pay for portions of Medicaid, SCHIP, or universal healthcare The report will describe the comparison of the alternatives versus the Patient Protection and Affordable Health Care Act. It will go onto mention the constraints of the alternatives as well.
Finally, the report will list my recommendations on how to make the Patient Protection and Affordable Health Care Act a perfect fit for Hispanic families and children that are below the poverty line in America. The recommendations will have a description, rationale, information on how to implement the program, and an evaluation of the Affordable Care Act as a whole. Some of the recommendations include: building a community based agency to ensure that Hispanics understand and utilize every service available to them to obtain insurance, to provide a program for individuals with pre-existing conditions that were denied medical coverage before the Affordable Care Act passed, and an emergency room visit cap for those who tend to abuse the system. The final evaluation will sum up the entire paper, and mention why I feel the Patient Protection and Affordable Care Act is a suitable choice for the United States healthcare system reform.
For the past several decades the Hispanic population has flourished in the United States, becoming the largest group of minorities in America (Mitchell & Tienda, 2006). With the recent emergence of the Hispanic population there is a high demand for them to have adequate resources and benefits along with the rest of society. Unfortunately, the majority of the minorities do not receive the same attention and benefits as other ethnic groups do for several reasons. Among the factors are, cultural and language barriers, low socioeconomic and education levels, racial prejudice, and discrimination (Ruiz, 2002). When many Hispanics enter the country, they find low paying jobs that do not include benefit packages. Without employer provided health insurance the minorities are forced to either pay out of pocket or forego insurance completely. While it is a travesty that so many Hispanic people are uninsured, the real concerning issue is the children. It is estimated that 31 percent of Hispanic children are uninsured in America (Flores, Olson & Tomany-Korman, 2004).
Since the 1900s, political leaders have struggled to improve the health policy for children in the United States. In 1909, President Theodore Roosevelt organized the first White House Conference on Children, which followed with the creation of the Children’s Bureau in 1913. This was the first effort to address the millions of American children that suffered from the effects of poverty and poor health (Yarrow, 2011). In 1921, the Sheppard-Towner Maternity and Infancy Protection Act was created. This was the first time that the federal government became directly involved in the needs of children and their mothers. This act allowed 3,000 health-care centers to be established nationwide. Unfortunately, the funding expired eight short years later. The Mid-Century White House Conference on Children and Youth held by Harry S. Truman in 1950 focused on children’s health care and resulted in 67 recommendations; however, only a few became law by the 1960s and expanded federal support for child health programs (Yarrow, 2011).
In 1965, Medicaid was enacted, assisting low-income children, pregnant women, people with disabilities, and other vulnerable populations to pay for their medical bills. The Medicaid program was expanded in 1986 which benefited 59 million children and increased access to primary care for children in families below the poverty line. The State Children’s Health Insurance Program (SCHIP) was enacted in 1997 and assisted needy children who exceeded the income guidelines in order to qualify for Medicaid (Yarrow, 2011). SCHIP was put into place to allow states the opportunity to increase coverage to children, whose family income is 200 percent of the federal poverty level, and even higher using Medicaid eligibility (Kenney & Haley, 2001).
Current Context. Although government programs such as Medicaid and SCHIP cover 40 percent of the families below the poverty line and about one-quarter near the line, there are approximately 50 million uninsured Americans (Kaplan & Inguanzo, 2011). According to data from the Children’s Defense fund (2011), there are more than eight million uninsured children in the United States and millions more are underinsured. Approximately 3.1 million of these children are Hispanic, which is an alarming statistic. Texas has the highest rate of uninsured children at 19.2 percent. These uninsured and underinsured children are less likely to have a regular source of healthcare and or routine doctor visits; they are also less likely to receive care for injuries, less likely to receive dental care and immunizations (Avruch, Machlin, Bonin, Ullman, 1998). In a study conducted about racial and ethnic disparities, only 66 percent of Hispanic families reported that they took their children to age appropriate well-child visits (Flores, Olson, Tomany-Korman, 2004).
Importance of the Problem. Families who are uninsured or underinsured live in constant fear of not knowing if they will receive medical care when needed. Lack of healthcare benefits is extremely daunting, as there are many children that are not receiving the medical care they need. Not receiving appropriate medical care can result in serious health problems which can result in premature death. When a family doesn’t have health insurance, they are more likely to postpone necessary care and forego preventative care. Those who delay medical care for fear of medical bills are not only endangering themselves, but it is also a downward spiral that will lead to higher health care costs for the entire nation. When an uninsured patient cannot pay their medical bills, it falls on the insured population, the hospitals, the doctors, and the government. Therefore, it is important for all individuals to carry proper health insurance coverage, which is why a universal health care reform is in the process of being put into place today.
Statement of the Problem
There are too many individuals living in the United States lacking proper healthcare insurance; a majority of them are Hispanic children. Without proper insurance, many people will decline medical treatment and risk the possibility of worsening their condition or even death. To correct this issue, President Obama signed into law the Patient Protection and Affordable Care Act of 2010 (see Appendix A). The Affordable Care Act is a policy that will change every aspect of healthcare as Americans know it. It is the largest modification to the United States healthcare system since Medicare and Medicaid were instated in 1965 (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). While many people feel that the act will help poverty stricken families afford insurance, problems are assure to arise during the implication process.
The Affordable Care Act will drastically affect Hispanic families and children who are uninsured or underinsured by expanding Medicaid and the SCHIP programs, also giving federal subsidies for the poor. The policy encompasses several provisions that went into effect in June 2010. The entire act will be put into place in 2014 (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). In a journal written by five physicians describing the healthcare reform, an explanation of the essentials regarding what will change is given in thorough detail. Manchikanti, Caraway, Parr, Fellows and Hirsch’s (2011) study reported several details, including an obligation for individuals and businesses requiring that nearly every citizen in America have an approved level of health insurance or pay a fine. The mandate is upheld by the law, and if ignored, the individuals and businesses could face a fine (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). This will help Hispanic families who work for a business that didn’t offer health insurance in the past. It will also ensure that millions of children who were uninsured receive the medical help that they deserve. The policy will require all children to attend their well-child checkups and adults to have preventative care visits. Preventative care is extremely important, and can detect major health concerns at an early stage. The earlier a problem is caught, the better chance that they can implement a treatment plan that will provide the patient with optimal health. Americans receive approximately half of the preventive care services that are recommended (Thorndike, Sonnenberg & Healey, 2012). This portion of the Affordable Care Act could negatively affect poverty stricken Hispanic families who do not utilize the resources available. Unfortunately, a problem ensues when the families are fined but don’t have the monetary resources to pay the fee. When the fee goes unpaid, will the parents face jail time? What will happen to the children then? The spiral of questions and complications rolls out of control, and tax payers are still going to be held accountable for the individuals who refuse to buy insurance or pay the fine.
The second fact about the Affordable Care Act that the physicians reported on is a system of federal subsidies to completely or partially pay for the now required health insurance for approximately 34 million Americans who are currently uninsured with Medicaid and additional government operated programs (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). This will help Hispanic children and families by paying the majority of, if not all of the medical bills. A visit to an emergency room for an individual without insurance can set a family back hundreds of thousands of dollars, which could potentially bankrupt them. With the assistance of the government for poverty stricken families, the fear of medical bills would vanish. Parents would more than likely take their children to the doctor for preventative care, and emergency visits would decline. Unfortunately, there are also negative impacts that come from this portion of the policy. Recent data indicates that millions of children are uninsured despite having family incomes low enough to qualify for Medicaid and SCHIP programs (Kenney & Haley, 2001). If the programs are there already and not being utilized, will the fine for not having health insurance be convincing enough to ensure they apply to the programs? Opponents for the law argue that adding 34 million additional citizens to government programs will add an additional tax, to an already growing percentage that tax payers can barely afford. Fortunately, the physicians report shows that the only tax penalties to citizens will be for those who do not have a health plan through their jobs or purchased one on their own. An indirect penalty will be retained for individual plans with new taxes on high-end health plans, and for those who do not obtain insurance at all (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011).
The next important impact mentioned by the physician’s study is that insurance companies would be barred from rejecting coverage to individuals who have pre-existing medical conditions (Manchikanti, Caraway, Parr, Fellows & Hirsch, 2011). This portion of the policy will greatly affect Hispanic families and children with pre-existing medical conditions, who were denied health coverage due to a serious health condition. Imagine a Hispanic child whose family does not have health insurance, and he is diagnosed with a life altering disease. The child needs immediate treatment, but the parents cannot afford the medical bills that have already accumulated, let alone the new bills the treatment will warrant. The child’s mother has applied for medical insurance several times, but they have been denied. The family’s income is a few hundred dollars shy of Medicaid and SCHIP eligibility, and has nowhere to turn. The child suffers, and dies prematurely from a disease that could have been prevented. Unfortunately, these types of cases happen daily. The hope is that the Affordable Care Act will prevent situations like these from occurring, with assuring all individuals healthcare no matter their current state of well-being.
The final two major impacts of the Affordable Care Act, found by the physician’s study, are the extensive new requirements on the health insurance industry and numerous regulations on the practice of medicine. While these portions of the law will help control some of the health insurance cost, there is no information found on the impacts of racial and ethnic disparities. A recent study from the Institute of Medicine called for attention and action to the inclination for racial and ethnic minorities in America to receive low quality health care compared to Caucasian individuals, even after modification for access-related aspects such as insurance coverage and income. The same study found that 30 percent of Hispanic parents felt that their primary care provider “never or only sometimes takes time to understand child’s specific needs” (Flores, Olson & Tomany-Korman, 2004).