October 15, 1999
By Roberto Garcia De Posada
Too many Hispanic Americans do not have access to even basic health insurance coverage. In fact, by every measure, a lack of access to affordable health insurance disproportionately affects America's large and growing Hispanic community.
According to Aetna U.S. Healthcare, the highest uninsured rate in the United States is among people of Hispanic origin. Over one-third, or 39 percent, of Hispanics were uninsured compared with only 14 percent for non-Hispanic whites. According to the Commonwealth Fund, in small- to medium-size companies with fewer than 100 workers, 63 percent of white workers have health benefits compared with 38 percent of Hispanic workers. This recent data confirms recent U.S. Census Bureau findings that 34.2 percent of Hispanics are uninsured, compared with 12 percent non-Hispanic whites.
There is a strong relationship between uninsurance and the kind of employment a person has.
The reason is simple: Most Americans get their health insurance through their place of work. Moreover, in getting their health insurance through the workplace, they are also eligible to get large and, under current law, unlimited federal tax breaks for the purchase of health insurance. There is no such tax relief for workers who get health insurance outside the workplace or for workers and their families who cannot get employer-based health insurance.
Today, 65 percent of the uninsured are in working families where the breadwinner works full time. Because Hispanic workers are heavily concentrated in the service industry and in small businesses-working for firms that do not or cannot offer them health insurance coverage-they are disproportionatley found outside of the normal channels of health insurance in the United States.
An overwhelming majority of the uninsured in the Hispanic community are working poor. Most Americans are personally familiar with such cases. But, for purposes of illustration, consider Martha Sanchez, a single mother of two in Miami. Martha works as a receptionist for a small law firm, earning approximately $10 per hour. Her employer does not provide health insurance, and she cannot afford to buy an individual health insurance policy.
This is the case for many Hispanic workers. They are not poor enough to qualify for Medicaid, a government health program, but are too poor to afford private health insurance. In addition, there is a high degree of mobility in the Hispanic workforce. And, as noted, the current system of employment-based health insurance is simply leaving too many working people who have families and are willing to work without affordable insurance.
Access to affordable private health insurance is a problem that disproportionately affects the U.S. Hispanic community.
While some policymakers would like to consign a large number of America's working poor to Medicaid, or some expanded version of Medicaid in which individuals and families will only get the benefits government officials give them, there is a superior alternative. The best option is to change the tax treatment of health insurance and give low-income working families without health insurance either tax credits or vouchers to help them purchase private health insurance best suited for their families.
Such a new system, with a level playing field between employment-and nonemployment- based health insurance, would open up new opportunities for privately run ethnic, fraternal and religious organizations, particularly in the Hispanic community, to sponsor health options and plans, run clinics, and establish new medical practices that are sensitive to the particular health-related needs of the community.
(Roberto Garcia de Posada serves as the Executive Director of the Hispanic Business Roundtable based in Washington, D.C.)
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