As the Build Back Better Act moves to the Senate, the ongoing pandemic continues to underscore that expanded health insurance coverage for all Americans, and especially Latino families, is essential to the national recovery.
By Matthew Snider, Senior Health Policy Analyst, UnidosUS
While longstanding coverage disparities were exacerbated by the COVID-19 pandemic, there is some good news. A set of measures within the House-passed bill has the potential to make significant coverage improvements among the Latino community and may one day be recognized as the biggest advancement in health equity since the enactment of the Affordable Care Act (ACA) in 2010.
The ACA extended insurance coverage to more than four million Latinos, and the American Rescue Plan Act (ARPA) built on this by improving affordability in the Marketplace which has shown good early results for Latinos.
Nevertheless, racial and ethnic disparities remain entrenched in our health care system. Latino and Black families are being hit disproportionately hard by COVID-19 because of unequal access to coverage. At the same time, some states still operating in a pre-pandemic mindset have kept barriers to coverage in place despite their impact on minority children.
The Build Back Better Act gives Congress an opportunity to deliver additional relief for American families still suffering from the pandemic and to rebuild our health system in a way that is stronger and more equitable than before. The House bill includes two key policies that UnidosUS advocated for throughout this year, as well as other longstanding health priorities that would improve access to affordable health coverage for millions of Latinos.
Advancing equity is a key component of the Biden administration’s agenda, and while the ARPA put affordable coverage within reach for millions of Latinos, these changes will expire after next year. A more expansive and structural solution is needed, because, for more than 610,000 Latinos in 12 states, accessing affordable health coverage is nearly impossible due to some state leaders’ refusal to expand Medicaid.
The Build Back Better Act will deliver affordable access to care by closing the Medicaid coverage gap through subsidized Marketplace coverage. While the solution may be temporary under the current terms of the bill, it would put affordable coverage within reach for 2.2 million people (including the 610,000 Latinos) for the first time.
This coverage would have no premiums, include incredibly low cost-sharing for enrollees, and allow for year-round enrollment unlike ordinary Marketplace coverage. Importantly, the bill will also add expansion incentives for the remaining 12 states by increasing the federal share of costs for those states which have expanded.
The increased financial assistance included in ARPA for those traditionally eligible for Marketplace coverage would be extended through 2025 if the Build Back Better Act passes the Senate. As many as 2.6 million Latinos will remain eligible for zero-dollar plans and even more can get a plan for $50 or less per month. These changes are already benefiting Latinos who are taking advantage of the current Open Enrollment period but extending this assistance through 2025 will allow Latinos to remain enrolled in affordable health coverage for an even longer period.
What’s more, the bill will also provide 12 months of continuous coverage for children in Medicaid and CHIP which is critical in helping advance health equity and insulating children against delays or disruptions in health care. These provisions will benefit millions of Latino children currently enrolled in these programs, including at least 1.5 million Latino kids in Arizona, Florida, and Texas alone.
Not to be lost in the mix are the unprecedented investments in fostering an equitable approach to executing federal programs for children and families in Puerto Rico. This bill will bring greater financial stability to the island’s Medicaid program by permanently increasing the amount the federal government pays for U.S. territories’ expenses. Parity between the states’ and territories’ Medicaid programs should remain the long-term goal, but this is an important step towards ensuring that Puerto Rico can cover Medicaid costs as the health crisis persists.
President Biden and congressional champions will have a lot to celebrate when the bill is finally enacted into law with these health care measures at the center of their equity and recovery agenda. These provisions could also have important political payoff, go a long way to helping Latino families realize the benefits of the Build Back Better Act and give them greater confidence that government can meaningfully address racial equity.