BACKGROUND ON THE IMPACT OF HEALTH CARE PROPOSALS FOR HISPANIC
ELDERLY AND CHILDREN
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
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
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
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
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 Have Higher Rates of Certain Diseases, Such As Cancer and
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
II. MEDICARE REFORMS HAVE IMPORTANT IMPLICATIONS FOR HISPANIC
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
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
Increase the eligibility age to 67, which would have a
disproportionate impact on elderly Hispanics who are more likely to be
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
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
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
Proposed to restore access to health care for legal immigrant
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.
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