By Elizabeth de Armas and Luis Carlos López
Hispanic Link News Service
Now that the Supreme Court has validated President Obama’s hallmark Affordable Care Act, the states must grapple with interpreting and implementing its 2,801 pages. As the cliché goes, the devil is in the detail.
When the verdict was announced June 28, many Hispanic experts and organizational leaders hailed its passage as a victory. A follow-up survey by Hispanic Link News Service has found others are raising strong objections about some of its substantive provisions.
Senior research analyst for the health policy project at the National Council of La Raza, Kara Ryan, called it a “major breakthrough.”
Some six million Latinos would gain a pathway to coverage should the law be fully implemented in 2014, she asserted saying that this would translate to the highest single gain by any ethnic group.
Nearly one-third of the nation’s Hispanics are uninsured, as are 20% of African-Americans.
Chief Justice John Roberts shifted from his conservative stance to side with liberal justices when the Court ruled 5-4 that the president’s health package was constitutional.
Appointed by Obama predecessor George W. Bush, the Chief Justice affirmed that Congress has the authority to levy taxes. Roberts walked a fine line when he limited the federal requirement for states to expand Medicaid. Law scholars will debate ad infinitum why he chose to abandon his conservative colleagues.
Florida, which is 22.9% Hispanic, along with Iowa, Kansas, Louisiana, Nebraska, South Carolina, Wisconsin and Texas have said they will decline the Medicaid expansion: some experts project it will leave an estimated five million persons uninsured.
Texas Governor Rick Perry was the latest to reject the provision, telling Fox News July 9 that expanding it would be like adding “a thousand people to the Titanic.”
Perry’s state has a Hispanic population of 38.1%.
Seven other states — Alabama, Georgia, Indiana, Mississippi, Missouri, Nevada and Virginia — are leaning toward rejecting the expansion.
Florida Governor Rick Scott defines the nation’s insurance dilemma as a “health care cost problem, and Obamacare doesn’t do anything to address it,” spokesperson Lane Wright told Hispanic Link News Service.
In Nevada, which is 27.1% Hispanic, a spokesperson in the governor’s office told Hispanic Link they are reviewing all the information before making a decision.
Civil Rights attorney James Lyons maintained that while the law was upheld, the option for states to decline Medicaid expansion could be detrimental to Hispanics. “Everyone is saying, ‘Oh, the Supreme Court upheld the Affordable Care Act.’ Well, yes and no. They certainly didn’t for the poor people who are uninsured. There will be illusions that care is available, and it won’t be.”
Washington-based surgeon Wadi Gomero-Curé said the law will benefit the underserved. His criticism is that it is fiscally irresponsible.
“Instead of addressing Medicaid fraud, Obama proposed this law simply to pay for it,” he said. “This bill risks hurting our doctors and specialists for the sake of political goals. Although it will help Hispanics, I fear it will hurt medicine and therefore hurt everyone in the long run.”
Congressman Mario Díaz-Balart (R-Fla.) in a June 29 Spanish teleconference added another sticking point, “Unfortunately, the president has sold this as if it were a free handout where no one has to pay.”
Despite criticism and uncertainty, most Hispanic organizations remain optimistic.
Jessica González-Rojas, executive director for the National Latina Institute for Reproductive Health, said young Latinos have benefited from a provision of the ACA, which allows parents to claim their children on a health insurance plan until the age of 26. Over 700,000 Latinos are already reaping these benefits.
Come Aug. 1, women will be able to receive preventative care services such as mammograms, contraception and pap smears, with no copay.
As of now, the ACA does not cover undocumented immigrants, even those who can afford their own health insurance plan. They must rely on community health care centers and emergency Medicaid, which is more costly.
González-Rojas said the law limits Latinas in the areas of abortion services.
“We’re hopeful that there will be some wisdom in this legislative body to consider what is best for this country and providing care for all our people,” González-Rojas said. “It’s a battle… Until all of these people are included, we are not going to stop fighting.”
States declining Medicaid Expansion (Percents indicate Hispanic population in each state)
Florida: 22.9 %
Iowa: 5.2 %
Kansas: 10.8 %
Louisiana: 4.4 %
Nebraska 9.5 %
South Carolina: 5.3 %
Wisconsin: 6.1 %
Leaning toward No (Percents indicate Hispanic population in each state)
Nevada 27.1 %
Texas: 38.1 %
Alabama: 4.0 %
Georgia: 9.1 %
Indiana: 6.2 %
Mississippi: 2.9 %
Missouri: 3.7 %
Virginia: 8.2 %
Elizabeth de Armas and Luis Carlos López are D.C. correspondents for Hispanic Link News Service. Email de Armas at firstname.lastname@example.org . Email López at email@example.com. This column is available in Spanish at HispanicLink.org.