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  • 1. U.S. Health Reform Law and Migrants Ed Martinez CEO San Ysidro Health Center May 12, 2010
  • 2. U.S. Health Reform Law
    • “ This reform is the civil rights bill for the sick. And make no mistake about it: this is a civil rights issue on par with racism. With the passage of this bill, insurers can no longer discriminate against sick people simply because they are sick. What is being created is a system of health care that is fair for everyone and we leave behind a system that has been patently unfair to too many.”
    •   Robert K. Ross
    • President
    • The California Endowment
  • 3. Immigrants in the U.S. Total U.S. Population: 301 million Total Immigrant Population: 39.3 million Naturalized Citizens: 14.2 million Lawfully Residing Non-Citizens: 13.8 million Undocumented Immigrants: 11.9 million Source: Kaiser Family Foundation. “Immigrants’ Health Coverage and Health Reform: Key Questions and Answers.” 2009 December. http://www.kff.org/healthreform/7982.cfm
  • 4. Latino Urban and Farmworker Health Health Issue General Population Latino Urban Population Latino Farmworker Population Access to Care Health Insurance Environmental Health AIDS/HIV STDs Maternal and Child Health Mental Health Tuberculosis Oral Health
  • 5. Health Reform Law Overview
    • Patient Protection and Affordable Care Act
    • Health Insurance Mandate – requires U.S. citizens and legal residents to have health coverage
    • Health Exchanges – creates state-based exchanges where people can purchase coverage
    • Premiums and Cost-Sharing Subsidies – provides financial assistance through tax credits to buy coverage
    Source: Kaiser Family Foundation. “Summary of New Health Reform Law.” 2010 April 21. http://www.kff.org/healthreform/8061.cfm
  • 6. Health Reform Law Overview
    • Patient Protection and Affordable Care Act
    • Medicaid – expands Medicaid to 133% of federal poverty level
    • Employer Penalties – fines employers with over 50 employees who have employees that receive tax credits for coverage
    • Health Plans – face new regulations, such as eliminating pre-existing condition exclusions and ability to rescind coverage
    Source: Kaiser Family Foundation. “Summary of New Health Reform Law.” 2010 April 21. http://www.kff.org/healthreform/8061.cfm
  • 7. Health Law and Migrants Source: National Immigration Law Center. “How are Immigrants Included in Health Care Reform?” Posted 2010 April 28. http://www.nilc.org/ Issue Legal Immigrants Undocumented Immigrants Individual Mandate Yes, must comply No, are exempt Insurance Exchange Yes, may participate No, may not participate Premium Tax Credits Yes, are eligible No, not eligible Medicaid Yes, but 5 year waiting period No, not eligible Emergency Medicaid Yes, are eligible Yes, are eligible Emergency Services Yes, can access Yes, can access but are liable for service costs Nonemergency Services at Community Health Centers or safety-net hospitals Yes, can access Yes, can access
  • 8. Verification Requirements Source: National Immigration Law Center. “How are Immigrants Included in Health Care Reform?” Posted 2010 April 28. http://www.nilc.org/ Issue Insurance Exchange Medicaid Who Requires Verification? Everyone Everyone Citizens Verify through Social Security Administration database 1. Provide documents – U.S. Passport or Birth Certificate and an Identification Document 2. Verify through Social Security Administration database Legal Immigrants Verify by Department of Homeland Security database Verify by SAVE (Systematic Alien Verification for Entitlement), which is run by the U.S. Citizenship and Immigration Services Undocumented Immigrants Not eligible to participate Not eligible to participate Other Verification Information If information cannot be verified through database, can provide other documents N/A
  • 9. Health Reform’s Indirect Benefits to Migrants: Community Health Centers
    • Under the Health Reform Law, community health centers will receive $11 billion over 5 years beginning in fiscal year 2011
      • $9.5 billion to expand operations to serve nearly 20 million new patients
      • $1.5 billion to expand existing facilities and to build new ones
    Source: National Association of Community Health Centers. “Health Centers and Health Care Reform: Health Center Funding Growth.” 2010 April. http://www.nachc.com/healthreform.cfm
  • 10. Community Health Centers and Migrant Health Centers
    • There are 157 Migrant Health Centers (MHCs) nationwide that are usually housed in a community health center
    • MHCs are charged with providing comprehensive primary and preventive health care to migrant and seasonal farmworkers and their families
    • MHCs are available to patients on a sliding fee scale regardless of immigration status
    • In 2008, MHCs served more than 834,000 patients
    Source: U.S. Department of Health and Human Services, Health Resources and Services Administration. “The Health Center Program: Special Populations.” http://bphc.hrsa.gov/about/specialpopulations.htm