Accessing the ACA’s Full Potential

ACA

ACAAlthough research by a new Drexel professor has shown important increases in health care access for the United States’ Latino population under the Affordable Care Act (ACA), he feels expanding it to include undocumented immigrants could have the far-reaching positive impact the law was designed to achieve.

“The spirit of the ACA is to reduce disparities in health care access among the country’s most vulnerable populations. And it seems to be working,” said Alex Ortega, PhD, the new department chair of Health Management and Policy in the Dornsife School of Public Health. “But there remain segments of populations that are precluded, particularly the undocumented. And that’s economically foolish because they’re generally healthy, use little health care and could help stabilize the costs of health care for everyone.”

In the United States, there are 11.4 million undocumented immigrants, 81 percent of whom hail from Latin America.

Research by Ortega and his colleagues demonstrated that the probability of being uninsured in the Latino population is approximately twice that of peers in other ethnic groups, which included non-Latino whites and African-Americans.

Undocumented immigrants are precluded from participating in the health care marketplace established by the ACA and, as a result, approximately 60 percent don’t have health insurance, contributing to the low probability Ortega and his team uncovered.

As a result, most uninsured immigrants utilize emergency departments or other similar “safety net” points of care such as community health centers. Latino consumers make up 35 percent of those served by community health centers. Because federal funding makes up 40 percent of these centers’ funding, tax dollars effectively subsidize this care.

But the research from Ortega and his team shows that inclusion in the ACA Marketplace Exchange would prompt more primary care visits, which would reduce costly long-term chronic care in those federally funded centers.

From 2011, when the ACA began to be implemented, to 2014, when it was fully implemented, the probability of the Latino population visiting a physician grew by more than 9 percent. That was the greatest increase among any of the ethnic or racial groups in the study.

Ortega and the team also uncovered a 33 percent drop in the probability of the Latino population delaying or flat-out forgoing medical care from 2011­ to 2014.

An influx of undocumented immigrants into the ACA Marketplace Exchanges would also likely influence premiums. Ortega believes it would offset costs for sicker and older consumers in the Marketplace who typically need more expensive chronic care services.

“The undocumented immigrant population, generally, is younger and healthier, and doesn’t require a lot of expensive care from the health care system other than routine primary care and maternal and child health services,” Ortega said.

With this population moving away from indigent care, the savings would ultimately trickle down to the local taxpayers who subsidize indigent care at the local level.

“Community health centers are already shifting services and finding ways to improve health care with a nationally changing Latino demographic,” Ortega said. “Including the undocumented in the ACA will not pose too much of an additional burden on these centers and, in fact, they will benefit from having that population insured since many clinics are already seeing undocumented immigrants, as well as legally authorized immigrants and Latinos who are U.S.-born. Including them in the ACA will only be positive for everyone, and it is the morally right thing to do.”

Members of the news media who are interested in speaking with Ortega should contact Frank Otto at fmo26@drexel.edu or 215.571.4244.

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