Young Latinos’ Health Coverage Found to Be Lacking

Nearly 40% of the young Latino children in inner-city Los Angeles who qualify for Medi-Cal actually receive little to no health coverage, even though most were born in the United States and the majority of their parents are here legally, UCLA and Rand Corp. researchers reported Tuesday.

The 1992 study of Latino youngsters under 3 years old in East and South-Central Los Angeles neighborhoods also found, surprisingly, that those with working parents and those from two-parent households--traditional measures of social and financial stability--were less likely to be covered than other, less conventional family types.

Work and family status were more important than language barriers, the parents’ immigration status or parents’ length of stay in the United States in whether or not youngsters were signed up for Medi-Cal, the study found.

“It is somewhat counterintuitive,” said Dr. Neal Halfon, a pediatrician and lead author of the study published today in the Journal of the American Medical Assn. But, he said, it probably has to do with how parents traditionally hook into the Medi-Cal system.

Despite changes in the law several years ago that expanded Medi-Cal benefits to poor children in stable homes, most people gain access to Medi-Cal through Aid to Families With Dependent Children, which uses joblessness and single parenthood as eligibility criteria, Halfon said.

The Medi-Cal system “hasn’t reached out to the working poor,” Halfon said. And that describes many Latino families, especially recent immigrants who tend to work in menial, low-wage jobs that offer no health benefits.

Other Latino health care advocates said Tuesday that the UCLA-Rand study confirms what they suspected: Latinos are generally underserved when it comes to health care coverage. In 1992, 26% of Latino children under 18 years old were uninsured, compared to 10% of whites and 14% of African Americans.

“They may not realize they are eligible for public benefits because they are working,” said Amy Dominguez-Arms, policy director for Children Now, a Sacramento-based advocacy group. “Also, we should look to streamline the application process [for Medi-Cal] so it is not so lengthy and daunting.”

Children Now is supporting two bills soon to be introduced in the state Legislature; one to simplify application and the other to expand eligibility, she said.

Halfon said the UCLA-Rand study suggests that simply broadening eligibility for Medi-Cal is not sufficient to improve poor children’s access to care; more outreach in Latino communities is needed to make sure kids are signed up and continuously covered.

He also argued that restricting access to health care through federal welfare reforms and Proposition 187, the initiative that would ban undocumented immigrants from many public health and social services, will only make the problem worse for Latino families.

“They are just throwing new roadblocks up,” Halfon said of state and federal officials. “The innocent victims of this policy are many children, most of whom are citizens by virtue of the fact that they were born here. Many of them are in our schools and are going to live the rest of their lives in this country.”

A state health official said Tuesday that Proposition 187 applies only to people who are here illegally, and that federal health care reform will not affect the Medi-Cal benefits of legal immigrants who are already here.

Katherine Lowell, assistant secretary of the state Health and Welfare Agency, said the Wilson administration has made several efforts since the study was conducted to bring health care to poor families and young children. One example is the state’s Access for Infants and Mothers program, launched in 1993, a low-cost prenatal program with broader eligibility criteria than Medi-Cal, she said.

Another major step has been bringing millions of Medi-Cal recipients into managed care, which tends to emphasize early, preventive services, Lowell said.

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Health Access

Two in five Latino children eligible for government medical insurance in East and South-Central Los Angeles had little or no coverage according to a study of 800 households with children. 1 to 2 years old. Here is an insurance breakdown:

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U.S. Citizen Legal Immigrant Illegal Immigrant Eligible for Medicare 66.2% 86.3% 92.1%

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Health Insurance Status

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U.S. Citizen Legal Immigrant Illegal Immigrant Private Insurance 32.0% 18.2% 9.2% Continuous Medical 49.8% 39.5% 43.7% Episodic Medical 12.2% 22.4% 25.2% Uninsured 6.0% 20.0% 21.9%

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