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Health Care Reform


Health Care Reform Including migrants and other vulnerable populations - Al Hernandez Santana, LCHC Presenter Disclosures (1) The following personal financial ... – PowerPoint PPT presentation

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Title: Health Care Reform

Health Care Reform
  • Including migrants and other vulnerable
  • - Al Hernandez Santana, LCHC

Presenter Disclosures
Al Hernandez Santana
  • (1) The following personal financial
    relationships with commercial interests relevant
    to this presentation existed during the past 12

No relationships to disclose.
(No Transcript)
Learning Objectives
  1. Recognize complexities of federal immigration law
    and allowable state options to cover immigrants.
  2. Identify three reasons for providing coverage.
  3. List 3 programs or clinic facilities that service
    migrant and seasonal workers.
  1. Articulate previously failed efforts to cover
    undocumented children or adults in public health
    insurance programs.
  2. Assess the political landscape that may bear on
    future efforts to include migrant populations as
    part of comprehensive reform.

California has high number of immigrants and
  • California has the largest population of
    immigrants of any state, about 10 million.
  • The 2008-09 budget approved many cuts to health
    programs immigrants rely on.
  • Counties with highest rates of uninsurance have
    corresponding low rates of employment-based

Immigrants in U.S. Labor Force
  • Recent Mexican immigrant men have a 94 labor
    participation rate.
  • Mexican immigrant women labor force rates are
  • Low-wage industries rely heavily on Mexican
    immigrant men.
  • Jobs filled by Mexican immigrants are the least
    likely to offer health insurance.

Percent of non-fatal occupational injuries and
illnesses among Latinos resulting in days away
from work, by type of injury (U.S.
1998-2000)Source UCLA, UC Berkeley Schools of
Public Health, Health Initiative of the Americas
Legal Status of Immigrant Population,
2002Source Urban Institute estimates, Mar. 02
Current Population Survey
34.5 Million U.S. Total
Immigrants R UsSource Public Policy Institute
of California, and others
  • One in four Californians is an immigrant, a
    higher proportion than any other state.
  • Most CA immigrants are from Latin America (56)
    or Asia (34).
  • About one in eleven workers in California is an
    undocumented immigrant.
  • Illegal immigrants often live in families with
    legal U.S. residents.
  • Growth has slowed in California, and second
    generation U.S.-born children are outpacing
    immigrants as the major source of Latino growth.
  • Two-thirds of California adults favor some form
    of legalization.

Health Insured Latinos by Annual Income,
2002Source The Pew Hispanic Center/Kaiser
Family Foundation
Immigration Law and Welfare Reform (PROWRA)
  • Federal legislation restricts many immigrants,
    particularly recent immigrants, from qualifying
    for or enrolling in Medicaid and SCHIP.
  • The passage of PROWRA in 1996 imposed
    restrictions on immigrants eligibility for
    public programs in federal welfare reform.
  • The 2006 citizenship verification requirement for
    Medicaid eligibility all reflect a widespread
    belief that public benefit programs are a magnet
    for undocumented immigrants. (UCLA Health
    Research Brief, Jul.07)

A mishmash of programs, services and health
  • Family PACT program
  • Emergency Medi-Cal and pregnancy services
  • Child Health and Disability Prevention program
  • Vaccine for Children program
  • Medically Indigent program varies by county MISP
  • Emergency Rooms
  • Public hospitals, burn units, trauma centers
  • Expanded Access to Primary Care 330-FQHCs,
    Look-Alikes, Free Clinics, Rural Health Clinics

Why provide insurance coverage?
Public health outbreaks Economy - time loss from work
Stopgap inclusion, push for Reform Social contract (e.g. Workers compensation)