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Overall, California Latinas/os stand to gain the most with the ACA, whether currently insured or uninsured.

Written by Marisol Franco for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

We are now in the aftermath of the historic and significant Supreme Court ruling in favor of the Affordable Care Act (ACA). Our celebrations have simmered down and now we are analyzing what it all truly means and educating our  communities, while pushing back against the relentless opposition (i.e. the 33rd vote by the House to repeal ACA).

As I monitored the SCOTUS blog at the crack of dawn on the day of the ruling, I reminded myself that my mother, who had already been at work since 5 a.m. inside the hotel where she has worked for over 35 years, probably did not hear about the decision. While those who work on reforming our health care delivery system blasted emails, tweeted, blogged, and spoke with media, I wondered what she would have thought if she heard President Obama speak. Despite having a health policy wonk for a daughter, she would probably still wonder how this decision affects her, as most people did that morning and still do.

Despite the onslaught of reporting that day, the majority of discussions did not address how the ACA would benefit Latina/o individuals and families. Based on a xenophobic narrative, coverage about the fastest growing ethnic group in the country falsely pegs Latinas/os as immigrants who "drain" the system, and ignores contributions of immigrant and non-immigrant families as well as the less than half of Latinas/os who have access to job-based health insurance.

Overall, California Latinas/os stand to gain the most with the ACA, whether currently insured or uninsured. Latinas are the most uninsured group in the state with 4 out of 10 of us lacking health coverage. With this decision, over 2 million more California Latina/os will have access to affordable health care in 2014. It will also help the Latinas/os who already have employer-based coverage through regulatory and broader public health provisions.

My family is part of the 38 percent of Latinas/os in California who have employer-based coverage. Despite a debilitating work-related injury to her shoulder, my mother continues to work full-time through the pain she feels when cutting fruits and vegetables for the hotel restaurant, so that she can obtain health coverage for herself and two of my younger siblings. Latinas/os value health care and will often go to great lengths to obtain affordable health care for their families.

For California Latinas/os, the ACA means:


  • About 1.1 million California Latinas/os who are low-income citizens or qualified immigrants with incomes under 133 percent of federal poverty level ($30,657 for a family of four) will qualify for Medi-Cal.

  • More Latinas will have access to no-cost basic women's preventive health, including contraception and cancer screenings.  This is extremely important for Latinas who are disproportionately affected by breast cancer and cervical cancer.

  • More families will have access to no-cost preventive care, including physical exams and immunizations.

  • More funding will go to community health centers, where anyone regardless of insurance or immigration status can receive care.

  • For those whose employers do not offer health coverage, which is a large percentage among Latinas/os, the ACA will provide tax credits to families on a sliding scale to purchase their own insurance through new insurance marketplaces called Exchanges.

The ACA also keeps insurance companies in check:


  • Insurance companies now have to justify to the Insurance Commissioner if they plan to raise their rates by more than 10 percent.

  • Insurance companies can no longer charge women more than men for the same insurance policy.

  • Insurance companies can no longer deny coverage to children for pre-existing conditions.

  • Insurance companies must spend the bulk of our premiums on providing care and not CEO bonuses. Families will receive rebates for un-spent premium dollars.

While we share and celebrate the positive changes that the ACA has already accomplished and those to come, we must also continue to fight for equal access to health care for everyone in our communities, specifically our undocumented brothers and sisters. Twenty-six (26) percent of uninsured Latinas/os in California would be excluded due to citizenship and immigrant clauses that prohibit undocumented residents from participating in public programs, receiving tax credits and using their own money to purchase coverage through the Exchange. We must inform immigrants about which public programs and health centers they can access, and at the same time work on solutions to cover all Californians, regardless of immigration status.

Opponents of the ACA can use scare tactics to inflame "the taxpayers" about all of the immigrants they would have to be responsible for providing health care - but the bottom line is that when families in our community cannot access care we all lose. Emergency care costs are mounting and safety net providers are over-burdened and under-resourced. And let us not forget that our immigrant families are also "taxpayers" and contribute invaluably to California's and the nation's vitality. Immigrants, regardless of status, are equally entitled to their human right to health care.

This "win" was not just for the policy and advocacy community, it was for families--like mine, like yours, and many other Latina/o families in California. Because of the Supreme Court ruling, I can rest assured that when my mother, who is still far from Medicare eligibility, can no longer work the required hours, we will be able to find her affordable health coverage.  

While most people have moved on to the latest breaking news, the decision did pique people's interest. They want to know more about the ACA and how it will affect them. We all have a responsibility to inform our family, friends and broader communities about the details and importance of the ACA especially as conservative politicians push back and muddle the facts. We must speak clearly, loudly and relentlessly. Now is the time to drown out the naysayers and stand up for health care for all.


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