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Moises Enriquez
and María T. Soto both migrated to Ohio from Humacao,
Puerto Rico six months ago, and both are struggling to cover
their health care costs. While Ms. Soto has Medicaid and
Medicare insurance, Mr. Enriquez has no health insurance and did
not qualify for Medicaid.
They attended a community health forum at Lorain’s El Centro
de Servicios Sociales, Feb.1, 2012, to learn more about
available health insurance plans.
Speaking to a crowd of over 30 people, Mayra E. Alvarez,
of the U.S. Department of Health and Human Services, said
President Barack Obama’s Affordable Care Act is holding health
insurance companies accountable and granting “more Americans,
more Latinos” access to health care.
The federal law, signed by Obama in March of 2010, places
multiple federal regulations on health insurance companies
including preventing them from denying coverage to patients
because of pre-existing conditions. Though most regulations have
already rolled into effect, all will fully go into effect in
2014.
The Affordable Insurance Exchange, beginning in 2014,
will allow individuals and small business owners to “shop
around” and purchase a health insurance plan that best suits
their needs.
“If there are changes (to the regulations on health insurance
plans), you can’t take advantage of them because you don’t know
they exist,” Mr. Enriquez said “There is nothing better than
being informed.”
Ms. Alvarez said Latinos are the most uninsured and are a
community underserved in health care.
One in three Latinos in the U.S. does not have access to
health insurance, and 1 in 2 Latinos in the country does not
have access to a consistent doctor or a family doctor, Alvarez
said.
She said there are roughly 34 million U.S.-Americans and 9
million Latinos in the country without health insurance.
“It’s inexcusable for people to not have access to health care
when it’s tied to every piece of our well being,” said Ms.
Alvarez, director of Public Health Policy in the Office of
Health Reform.
Latinos are also not investing in preventative care services but
instead are using the emergency rooms as a last resort, often
when their illness has advanced to the late stages, Alvarez
said.
“As a result of that, they get sicker, and die sooner,” Alvarez
said “If you look at rates across these – breast cancer,
cervical cancer, diabetes, heart disease, our Latino community
is often one of the hardest hit, and what’s most tragic is that
many of these illnesses are preventable.”
Alvarez said the Affordable Care Act’s goal is to grant access
to health care for these underserved communities. More Latinos
should go to the doctor and participate in preventative care,
she said.
The Affordable Insurance Exchange is a notable component
of the Affordable Care Act to take place in 2014. The
exchange is a transparent and competitive health insurance
marketplace available online. If an employer does not offer
health insurance, individuals and small business owners will be
able to directly purchase a health insurance plan that best fits
their specific needs. The exchange lists insurance plans by
state, and plans that meet certain benefits or costs standards.
The websites,
Healthcare.gov in English or
CuidadodeSalud.gov in Spanish, run by the federal
government, currently list all the available health insurance
plans throughout the country. In 2014, only those plans meeting
the federal government’s ground rules will be listed, Alvarez
said.
The Affordable Care Act, Alvarez said, was meant to protect and
better inform the consumer on what exactly is being purchased
within their health insurance plans.
Alvarez said the law is “doing away with some of the worse
insurance company abuses,” like denying children’s or adults’
coverage because of pre-existing conditions, and the insurance
company’s ability to end an individual’s coverage “for no
apparent reason,” or because of paperwork errors.
But because those regulations will not fully go into effect
until 2014, the federal government has recommended a new
pre-existing conditions insurance plan available in all 50
states, run by the states or federal government. It is available
by visiting
pcip.gov.
Alvarez said there are 130 million US-Americans living with
pre-existing conditions, like Enriquez, who said he will attempt
to apply for that insurance plan.
The law would limit the insurance companies’ ability to use the
consumers’ premium dollars for administrative purposes or their
ability to raise premiums without a just cause. Before the law,
they could spend 60 percent on administrative costs. The law
instead would require the companies to spend 80 percent of the
premium dollars on actual medical care or the improvement of
medical care services. “If they don’t, you get a rebate,”
Alvarez said.
Alvarez said the Affordable Care Act has allowed 2.5 million
young adults up to the age of 26 to stay on their parents’
health insurance plan.
Plus, she said the law is making an $11 billion investment into
community health centers in underserved communities throughout
the country and expanding the health care workforce in those
areas. The medical staff or doctors choosing to stay in these
underserved communities for two or four years are having their
student loans repaid, she said.
Alvarez said the law is strengthening the Medicare program by
eliminating cost sharing requirements and by re-shifting tax
dollars to focus on fraud and abuse.
El Centro’s Executive Director
Victor Leandry said he and his team are “very excited”
that the agency’s vision has become a reality: using the
community room within their new building for hosting these types
of educational events. Many more organizations are in line to
provide educational programming at the agency, to be announced
in the near future.
“That is crucial for this community,” Leandry said.
Access to health care, Leandry said is “a topic that I think is
very important for the Latino community.”
Check La Prensa for future events at El Centro.
Vea este artículo en español la próxima semana.
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