Latinos Cited as Having Least Medical Coverage

Latinos have poorer access to medical care than other Americans, primarily because they work in lower-paying jobs without the benefit of medical coverage, yet earn too much money to be eligible for most state insurance programs, according to a congressional report.

The General Accounting Office, the investigative arm of Congress, said that 33% of the estimated 17 million Latinos in the United States had neither private nor public medical insurance in 1989, compared with 19% of black Americans and 12% of whites.

Most of the uninsured Latinos were among the working poor, rather than the unemployed, the report said. Of those under 65 who were uninsured, nearly 80% belonged to families with employed adults, it said.

“A third of Hispanics are uninsured, either because they cannot afford it, because their employers do not provide benefits or because Medicaid requirements make them ineligible for coverage,” said Raul Yzaguirre, president of the National Council of La Raza, an advocacy group that represents approximately 2 million Latinos.

The GAO report, commissioned by the Congressional Hispanic Caucus and the House Select Committee on Aging, said that Latinos must either reduce their reported income or increase their medical expenses to qualify for state Medicaid programs, which provide coverage for the poor.

The report also noted that many Latinos have difficulty gaining access to Medicaid because they live in one of the states with the most stringent eligibility rules, such as Texas or Florida.

Texas, home to 22% of the Latinos in the United States, has the strictest criteria. To be eligible for state coverage, annual income must be less than $3,000.

California, however, has 34% of the nation’s Latinos and the least restrictive requirements. Thus, in 1989, a family of three earning $6,500 a year would have qualified for Medicaid in California but not in Texas, the report said.

Rep. Edward R. Roybal (D-Los Angeles), chairman of the aging committee, last fall co-sponsored with the Hispanic Caucus the hearings that prompted the GAO study. He urged that state Medicaid programs be expanded under a uniform, nationwide eligibility standard. Yzaguirre cautioned against such a system unless it also helps the states pay for the benefits.

Jane Delgado, president of the National Coalition of Hispanic Health and Human Services Organizations, stressed the report’s value in “debunking” myths that health care problems among minority groups are the same.

“Too often blacks and Hispanics have been lumped together into a catchall minority category,” said Delgado, whose group represents 200 Latino organizations across the country.

She said that Latinos more often suffer from chronic illness--hypertension, obesity, diabetes, infertility and certain types of cancer--all so-called pre-existing conditions that can disqualify them for coverage.

Although Delgado favored “bits and pieces” of the nearly 20 health care plans now proposed in Congress, including Roybal’s, she commended President Bush’s plan, which would remove certain chronic conditions as barriers to coverage.

Bush’s plan received a lukewarm reception in the Senate Finance Committee on Tuesday, as members welcomed the initiative but questioned the wisdom of some elements of it.