THE WHITE HOUSE

Office of the Press Secretary

     BACKGROUND ON THE IMPACT OF HEALTH CARE PROPOSALS FOR HISPANIC
                          ELDERLY AND CHILDREN

                              July 28,1999

I. HISPANIC MEDICARE BENEFICIARIES HAVE IMPORTANT NEEDS FOR QUALITY

HEALTH CARE AND PRESCRIPTION DRUG COVERAGE

The Number of Hispanic Elderly Will Triple in the Next Twenty-Five Years

• Today, Medicare provides health insurance to more than two million elderly and disabled Hispanics. Hispanics comprise about six percent of the Medicare population.
• By 2025, the Hispanic share of the elderly population will more than triple, and one in six older Americans, over eleven million, will be Hispanic.
• With the aging of the baby boom generation, by 2025 the number of Medicare beneficiaries is scheduled to double to 62 million.

Hispanic Medicare Beneficiaries Have Higher Than Average Health Needs and Lower Incomes

• Hispanic Medicare beneficiaries are more likely to be living in poverty than white Medicare beneficiaries. Nearly one-third of Hispanic beneficiaries have incomes below the poverty level ($7,740 for a single person in 1996), which is three times the poverty rate of non-Hispanic white beneficiaries (10 percent).
• Hispanic Medicare beneficiaries experience higher than average rates of health problems. Nearly half (46 percent) of all Hispanic Medicare beneficiaries perceive their health status to be fair or poor, compared to a quarter (26 percent) of non-Hispanic whites beneficiaries.
• Hispanic Medicare beneficiaries have higher rates of cognitive impairments such as Alzheimer's Disease and other forms of dementia. Twenty-eight percent of Hispanic Medicare beneficiaries have cognitive impairments, while twenty-two percent of their white counterparts have cognitive impairments.
• More than one in six (18 percent) Hispanic Medicare beneficiaries have long-term care needs -- measured by their ability to perform basic activities of daily living (ADLs), such as eating bathing and dressing -- compared to one in ten non-Hispanic white beneficiaries.

Hispanic Medicare Beneficiaries Have A Greater Need for Prescription Drug Coverage

• Hispanic Medicare beneficiaries are more than twice as likely to have no supplemental coverage to Medicare -- meaning they have no coverage for prescription drugs. Twenty-five percent of Hispanic beneficiaries rely only on Medicare -- meaning they have no prescription drug coverage at all. Only ten percent of non-Hispanic white beneficiaries have Medicare as their only form of coverage.
• Hispanic Medicare beneficiaries are significantly less likely to have private supplemental coverage to help cover their prescription drug needs.
  • Two-thirds of all white beneficiaries have Medigap or employer-sponsored retiree benefits compared to only a quarter of Hispanic beneficiaries.
  • Less than 10 percent of Hispanic beneficiaries have a Medigap policy, compared to nearly thirty percent of whites.
  • Thirty-seven percent of non-Hispanic whites have employee retiree health coverage - whereas only 17 percent of Hispanics do.

Hispanics Have Higher Rates of Certain Diseases, Such As Cancer and Diabetes

• Hispanic women have an incidence rate of cervical cancer nearly twice the rate of non-Hispanic women.
• The rate of breast cancer incidence has increased three times faster for Hispanic women than the rate of non-Hispanic women.
• However, older Hispanic women are the least likely to receive mammograms. Only 35.9 percent of older Hispanic women on Medicare receive regular mammograms, which is lower than any other racial group.
• The prevalence of diabetes in Hispanics is nearly double that of whites.

II. MEDICARE REFORMS HAVE IMPORTANT IMPLICATIONS FOR HISPANIC

BENEFICIARIES

The Administration's Medicare Proposal Includes Important Reforms That Are Critical for Hispanic Medicare Beneficiaries

• Hispanic Medicare beneficiaries would be helped from the Administration's proposal to eliminate copayments for benefits that cover preventive services. The Administration's proposal eliminates all deductibles and copayments for preventive benefits, such as cancer screenings, diabetes and osteoporosis. This proposal would help Hispanic Medicare beneficiaries who suffer disproportionately from these conditions and are less likely to have the supplemental coverage that would pay out-of-pocket costs to prevent and manage these diseases.
• The Administration's Medicare proposal provides prescription drug coverage for all Medicare beneficiaries, providing important help to Hispanic beneficiaries who are already twice as likely to have no supplemental coverage. Moreover, the Administration's proposal would waive all cost sharing for the new prescription drug benefit for Medicare beneficiaries under 150 percent of poverty, which would benefit Hispanic beneficiaries who tend to have lower incomes.

Republican Medicare Proposals Would Jeopardize Health Care for Hispanic Medicare Beneficiaries

Republican Medicare proposals would disproportionately harm Hispanic Medicare beneficiaries. Hispanic Medicare beneficiaries -- who have higher health needs and lower incomes than average -- would be disproportionately impacted by changes to the Medicare program that increase out-of-pocket costs or jeopardize the quality of care for Medicare beneficiaries. For example, the Republican proposals would:

• Add copayments for nursing homes and home health care that would disproportionately impact Hispanic Medicare beneficiaries who not only have lower incomes, but are more likely to have long-term care needs.
• Include premium support proposals that produce savings primarily by increasing premiums in the traditional fee-for-service Medicare program that would have a disproportionate impact on Medicare beneficiaries with lower incomes.
• Increase the eligibility age to 67, which would have a disproportionate impact on elderly Hispanics who are more likely to be uninsured.

III. HISPANIC CHILDREN ARE MORE LIKELY TO BE UNINSURED

• Hispanic children are the most likely to be uninsured. Twenty-seven percent of Hispanic children are uninsured whereas 17.6 percent of black children and 12.3 percent of white children are uninsured.
• Health insurance coverage is the major determinant of whether children have access to health care. Thirty-seven percent of uninsured children never see a doctor during the year, which is more than 2.25 times the rate for insured children. Children under the age of five go without routine preventive health care services at three times the rate of insured children. A study of children in western Pennsylvania indicated that health insurance improves access to care and health outcomes. At 12 months after their enrollment, 99 percent of the children had a regular source of medical care, and 85 percent had a regular dentist, up from 89 percent and 60 percent, respectively, before they were insured.
• Uninsured children have more unmet health care needs than children with health insurance. Uninsured children are more likely to be sick as newborns, less likely to be immunized as preschoolers, less likely to receive medical treatment when they are injured, and less likely to receive treatment for illnesses such as acute or recurrent ear infections, asthma, and tooth decay.
• There are 4.7 million uninsured children who are eligible for Medicaid but who are not enrolled. As states implement the Children's Health Insurance Program, there are likely to be even more uninsured children eligible for Federal/State health insurance programs that are not enrolled.
• Hispanic children have lower immunization rates. The immunization rate for Hispanic children in 1996 was 73 percent, compared to 80 percent for non-Hispanic white children.

IV. THE ADMINISTRATION HAS TAKEN MANY STEPS TO ASSURE CHILDREN,

INCLUDING HISPANIC CHILDREN, HAVE HEALTH CARE COVERAGE

• Enacted the largest investment in children's health in a decade. The Administration worked to pass the Children's Health Insurance Program (CHIP) that provides $24 billion over five years to states to cover millions of uninsured children.
• Launched a national outreach effort to sign up children who are eligible but not enrolled for Medicaid or CHIP. The Administration has launched a national outreach campaign working with child care centers, directing Federal programs that work with many of the same families to sign up kids, including conducting outreach to 700 community health centers; 1,400 Head Start, State Child Support and TANF sites; and 15,000 public housing cites; and launching a new toll-free number for parents to call to sign up their kids.
• Released new regulations to knock down major barriers that keep Hispanics from enrolling in health insurance plans. Studies have shown that thousands of families are not enrolling in critical programs, such as Medicaid, CHIP, or food stamps, because of the fear that receiving these benefits will have a negative impact on their immigration status. The Administration recently unveiled new regulations stating that the receipt of health care or other services cannot be used to deny an individual admission to the United States, their application to attain legal permanent resident status, or their request to remain in the country.
• Proposed to restore access to health care for legal immigrant children.

     The Administration has made a commitment to reverse unnecessary
     cuts in benefits to legal immigrants that had nothing to do with
     the goal of moving people from welfare to work.  Because of the
     Administration's leadership, the Balanced Budget Act and the
     Agricultural Research Act restored eligibility for Medicaid, SSI,
     and Food Stamps to hundreds of thousands of legal immigrants.  The
     Administration's new FY 2000 budget would build on this progress by
     restoring important disability, health, and nutrition benefits to
     additional categories of legal immigrants, at a cost of $1.3
     billion over five years.

                                 # # #