About a million people.
That's the number of Latino adults, ages 55 to 64, who don't have health insurance in the United States, according to Census survey estimates.
In practice, this implies limited access to early detection controls and treatments, which undermines their quality and life expectancy.
"People are dying younger than they should
from totally preventable issues, incredibly common diseases,
" Laura Guerra-Cardus, who has worked for more than a decade on campaigns for access to health in Texas, told Noticias Telemundo .
Latino adults are not only unprotected in the event of an unexpected serious accident, he explains, but they are unable to regularly treat conditions such as heart problems and depression and prevent complications.
This is the case of Perla Camarena, a 53-year-old Latina mother and grandmother from Texas, who was unable to buy high blood pressure medicine for two years or get checkups because she did not have coverage.
She lives in a trailer home in Mercedes, a town in southern Texas, and is caring for three of her grandchildren.
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Perla Camarena poses with one of her grandchildren.
Courtesy Camarena Family
“Two years feeling bad, without medicine.
It caused him a lot of stress," Perla's sister, Graciela Camarena, 51, told Noticias Telemundo.
Camarena is director of health access outreach for the Children's Defense Fund (CDF) in Texas.
But despite her experience on the subject and that Perla is a citizen, she was unable to help her obtain coverage due to the intricacies of the country's health insurance system, which leaves a large group of workers, older adults and heads of family without medical care.
In addition, the Camarena sisters live in the most restrictive state for access to health: Texas brings together a quarter of the adult Latinos without coverage in the country (263,000 of a total of more than 945,400).
And within Texas, they are in Hidalgo, the county with the highest percentage of people without health insurance in the entire United States: 43.4%.
Camarena was able to help her sister find a community clinic in the Rio Grande Valley to get primary care, but that didn't give her access to specialists.
Pearl's health worsened over time.
“The last time she went to the hospital, in an emergency because she got out of balance, she discovered that she now has diabetes and high cholesterol,” said Graciela, who is the one sharing the story with Noticias Telemundo since Perla recently fell ill with COVID-19 and her condition worsened.
The family endlessly searched for options, even if that meant leaving their home in Texas for another state with covered work.
“Having insurance saves lives,” explained Camarera, “and I want my sister to live.”
Thousands of preventable deaths
Government policies can significantly change access, experts say, and differences at the local level are illustrative.
Texas, Tennessee, Georgia, Nebraska, North and South Carolina have the highest rates of lack of coverage: About 30% of their Latino residents ages 55 to 64 do not have health insurance, according to estimates from surveys of households from the 2019 Census. None of these states had as of that year adopted or implemented the expansion of low-cost federal coverage called Medicaid.
In California, which did and also has a state health plan, 14% had no insurance.
The expansion of Medicaid was established by a provision of former President Barack Obama's Affordable Care Act that called for states to make low-income adults under 65 eligible for Medicaid.
This allows them to access medical care for heart disease, diabetes, mental health problems and other chronic conditions, and avoid premature deaths, multiple studies show.
An analysis by the National Bureau of Economic Research (NBER) calculates that in the states that adopted the expansion, 19,200 lives of people between 55 and 64 years of age could be saved from 2014 to 2017. In contrast, it is estimated that
15,600 adults died prematurely
in the states that did not adopt it.
In Texas, it was almost 3,000 people.
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65% of Latinos say they cannot afford their health care bills in the US National Health Survey, further affecting access to treatment and ongoing care.Francine Orr / Los Angeles Times via Getty image
Many of those who oppose stress that taxpayer money should be used to support these types of programs, and sometimes affect the budget deficit.
Others argue that Medicaid has losses from improper payments and requires reform.
“The program may be more wasteful than has been reported,” says Dean Clancy, a senior policy researcher at Americans for Prosperity, in a column for The Hill.
But there are specialists on the ground who have a different view.
“It is an investment in the quality of life of the elderly, and in the local economy and the health system.
Everyone wins when there is access to some type of coverage,” Adriana Cadena, campaign director for health issues at the National Immigration Law Center, told Noticias Telemundo.
Something simple like an ingrown toenail, he points out, can become a serious problem for a diabetic, a possible infection and amputation, if it is not treated in time, and consequently, the need to use system resources and generate a debt that the patient can not pay.
Cadena recommends Latinos with legal status to check if they qualify for Medicaid in their state, which they can apply for year-round, or other local programs.
Texas, Florida, Georgia and nine other states in the country, mostly in the south and center and with a Republican trajectory, have not extended the program to date, leaving two million citizens in a health limbo: they earn too little money to be eligible for Obamacare subsidized health plans and also do not qualify for Medicaid.
This prevented Perla Camarera from accessing the program.
“It is very restrictive.
In Texas, you have to be a parent, and have a very low income,
less than $320 a month
,” explains Guerra-Cardus, who is director of State Medicaid Strategy at the Center on Budget and Policy Priorities (CBPP) association. , and until last year was leading the
Sick Of It
coalition in Texas.
We must be a country where no one is denied access to health, which is something basic, which saves your life, which is a human right"
Laura Guerra-Cardus health activist
President Joe Biden in 2021 proposed a budget package that planned to spend billions of dollars on child care, health care and other services.
The bill also offered an affordable health insurance option to low-income adults in the 12 states without Medicaid expansion.
But the proposal failed to advance.
Biden has now made a change to Obamacare that would give 200,000 people access to coverage starting in 2023, and lower premiums for a million more.
The debate on these policies is still pending and returns to the scene now with the federal budget for 2023. What is at stake is "what country do we want to be," said Guerra-Cardus.
"We must be a country where no one is denied access to health, which is something basic, which saves your life, which is a human right," he remarked.
having to leave home
Perla Camarera and her husband have worked in warehouses, on assembly lines, in construction, among other trades.
“Hard, heavy work,” they describe her.
Sometimes they get a contract for a project or part time, but although they make a profit, it is not stable.
Doing a treatment implies having continuous health insurance.
The highest rate of uninsured in the United States occurs precisely in residents like them who do not have a full-time job.
More than 7.7 million workers ages 19 and 64 who had part-time employment in 2019 said they were uncovered in Census surveys.
The highest rates are found in states in the south and center of the country, with Texas leading the list: 31% of its part-time workers have no coverage.
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Perla was left at the end of 2021 in the care of her three grandchildren in Texas, while her daughter, the mother of the children, and her husband went out to look for a job in other places where they had relatives and acquaintances.
Her husband finally got a full-time job in Oklahoma last February with insurance for both of them, with which Perla hopes to go to specialists and start to recover.
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“That is a great change, a great help, and a blessing,” said Camarera.
“The sad thing is that now he is not at home.
He had to leave Texas, from his home, to be able to find something, a job that pays him fairly and that allows him to go to the doctor, ”he added.
High mortality rate in immigrants
In states like Texas, there is another worrying factor: a long tradition of anti-immigrant policies that limits even more policies that can improve access, explained Cadena, who works as state coordinator for The Reform Immigration for Texas Alliance.
This is worrying because the immigrant community is the hardest hit by the lack of insurance and its consequences, at all ages.
Recent research from the University of Southern California (USC) found that
young Latino non-citizens have a 40% higher mortality rate
than their US-born peers.
"We know that non-citizens are more likely to face poverty, segregation, and inadequate access to health care, mechanisms that negatively affect health," explained Jenny S. Guadamuz, lead author of the study and a USC postdoctoral researcher in the School of Pharmacy and the Leonard D. Schaeffer Center for Health Economics and Policy.
Latinos are also an ethnic group that suffers from high rates of stomach, liver and breast cancer, chronic liver disease, diabetes, heart problems and viral hepatitis, among other diseases, according to data from the National Center for Health Statistics.
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"If a migrant gets sick,
they have to use home remedies or if it's something serious they have to go to the emergency room
, but they don't treat bigger problems or chronic illnesses there," Jose Torres Casillas, leader of the policy and legislative area, explained to Noticias Telemundo. of the Health Access coalition in California.
What is necessary is to achieve preventive medicine, he indicated, and for this reason, they fought for complete coverage for undocumented adults.
California will expand the state's MediCal plan to all residents age 50 and older regardless of their immigration status in May.
Californians can now sign up and see if they are eligible.
Undocumented adults cannot buy insurance in the market or apply for Medicaid, but experts recommend
looking at local health departments and organizations for
affordable or no-cost options for coverage and care.
These benefits do not affect legal status and former President Donald Trump's public charge rule should not be feared, multiple specialists point out.
There are also public clinics and hospitals that they can attend, which are listed online by state.
a political problem
“The problem we have here is a political problem, not a policy problem,” Guerra-Cardus said.
“The states, the politicians, the Congress, can do much more to improve access to health, a basic right,” she said.
In California, for example, historic advances have been made for undocumented immigrants, but after years of campaigns.
First, in 2015, it offered health coverage to children under the age of 18, regardless of their immigration status.
Then, in 2019, the state also included young people up to 25 years old.
The latest advance comes for Latino undocumented adults, who will be able to have full MediCal coverage in May.
Motivation is the benefit for all.
“No community is truly healthy and safe until everyone has access to health care,” said Iván Barragán, Coordinator for Policy, Health and Public Benefits at the California Immigrant Policy Center.
We need access to health in order to be productive, take care of our family and be able to live.
Ultimately, that's what it's all about."
Graciela Cardenas Outreach Worker
“And at the end of the day, we are all Californians, no matter where we were born,” he added.
A key strategy, activists agree, is for families to bring their stories and the need to improve access to their representatives and leaders, by phone, by mail, with the help of local organizations.
In Texas, the Sick of It Texas
campaign was carried out,
bringing testimonies closer and unthinkable advances were made decades ago in the state, such as improving coverage for children and giving insurance to mothers after childbirth.
Graciela Cardena, who has been on the streets of Texas for a decade for access to health for her community, also emphasizes that it is a right of life.
“We need access to health to be able to be productive, to take care of our family, and to be able to live.
Ultimately, that's what it's all about,” she stated.