Latino Americans, the largest and fastest growing racial/ethnic group in the United States, are at higher risk for COVID-19 infection and are more susceptible to acquiring certain chronic or serious health conditions, such as diabetes, than White Americans, yet face several barriers in accessing health care coverage. Therefore, the guaranteed health coverage offered by Medicare and Medicaid is especially important to the Latino community, which has a huge stake in protecting, improving and strengthening Medicare and Medicaid.
In the United States, there are over 60.6 million Latino Americans, accounting for approximately 18 percent of the total population. Latinos are three times more likely to be uninsured than White Americans. While the Affordable Care Act (ACA) has decreased the rate of uninsured Latinos, under the Trump Administration that number has risen again and now over one in four lack health insurance coverage.
Latinos disproportionately work in blue collar industries such as agriculture, service and construction, where they are less likely to receive employer-sponsored health insurance. Even when an employer offers health insurance, many Latino Americans cannot afford to pay their share. Because Latino workers are concentrated in low-wage jobs, typically without pensions, it is also difficult for them to accumulate retirement savings during their working years.
In 2020, half of all people with Medicare lived on incomes of $29,650 or less per year – a little more than 200 percent of the federal poverty level. However, the median income for Latino Medicare beneficiaries was $13,650.
Medicare provides health coverage for most Americans when they reach age 65 or have been receiving Social Security disability benefits for 24 months. Currently, Medicare covers a portion of the health care costs of over 61 million Americans, including approximately 5 million Latino Americans. A change to eliminate the 24-month waiting period for those awarded disability benefits would improve Latino access to Medicare because Latinos are at higher risk of becoming disabled due to their work in blue collar industries.
Medicare’s guaranteed health care coverage is crucial to Latino Americans; however, it does not pay the full cost of hospital and doctor care, prescription drugs and other health services. Medicare beneficiaries must pay for Medicare premiums, coinsurance and copayments, plus health care services not covered by Medicare, like dental, vision and hearing. These out-of-pocket costs are a burden for Medicare beneficiaries with low incomes and high health care needs, including many Latino Americans who are elderly or disabled.
The share of income Medicare beneficiaries spend on health care is significant and growing. Medicare Part B and D premiums and cost sharing as a percentage of the average Social Security benefit increased from seven percent in 1980 to 14 percent in 2000 and to 24 percent in 2020. Out-of-pocket costs are a great burden for many elderly Latinos who are living on low incomes mostly made up of Social Security benefits.
Medicare Supplemental Coverage
Most Medicare beneficiaries have supplemental insurance (Medigap) to cover the gaps in Medicare, although Latinos are more likely than Whites to have only traditional Medicare. They are much less likely than Whites to have employer-provided retiree health benefits. A higher percentage of Latinos than Whites are enrolled in private Medicare Advantage plans, which provide Medicare benefits and often include prescription drug coverage as well.
Medicare Savings Program
Some low-income Medicare beneficiaries may be eligible for assistance to help cover their health care costs. The Medicare Savings Program, administered by the states, helps people with limited income and savings with some or all of their Medicare premiums, deductibles and coinsurance expenses.
Medicare Part D Low-Income Subsidy
The Low-Income Subsidy (LIS), also known as “Extra Help,” assists some low-income seniors (annual income less than $19,320 for an individual or $26,130 for a couple) with their Medicare Part D prescription drug costs. In 2020, low-income seniors may qualify for a subsidy if they have combined savings, investments and real estate not worth more than $29,520 for a married couple or $14,790 for a single person. (These amounts do not include a home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or Supplemental Security Income.)
Affordable Care Act improvements to Medicare
The ACA assists many older Latinos by providing preventive services, such as flu shots, diabetes screenings and an annual wellness visit – with no out-of-pocket costs and discounts on their prescription drugs. Thanks to the ACA, the Medicare Part D coverage gap no longer exists.
Medicaid, a joint federal and state program, provides health insurance to over 70 million low-income individuals in the United States. This includes coverage for seniors, people with disabilities, children and some low-income adults. Medicaid is an especially important source of health insurance for low-income Latinos.
In 2019, Medicaid provided coverage to over 16 million Latino Americans, who account for nearly one-third of Medicaid enrollees. Medicaid is a particularly important source of coverage for Latino children.
The ACA created new opportunities under Medicaid for coverage. As a result, some low-income Latino individuals may be able to receive health coverage in states that expand their Medicaid programs or through the new health insurance marketplaces. Since 2014, states have had the option to expand Medicaid coverage to adults with incomes up to 138 percent of the poverty level ($29,974) for a family of three in 2021. However, significant coverage gaps remain. In states that have not expanded Medicaid, many Latinos remain uninsured.
For individuals who aren’t eligible for Medicaid, the ACA also establishes health insurance marketplaces, where uninsured individuals can purchase health coverage. Tax credits are available to help moderate-income people buy health insurance. Because of the health insurance marketplaces, millions of uninsured Latino Americans gained access to new opportunities for coverage.
NATIONAL COMMITTEE POSITION
It is vital that America’s Latino population understands the essential health care needs Medicare and Medicaid can fill within the community.
The National Committee opposes proposals to cut Medicare benefits, repeal the Affordable Care Act and reduce federal funding of Medicaid, particularly since these actions would disproportionately affect communities of color, including Latino Americans. Requiring seniors to pay more for health care services than they already do could lead many to forgo necessary care, which could lead to more serious health conditions and higher costs. Given the lower incomes and poorer health of communities of color, including Latinos, benefit cut proposals would have a disproportionate effect on them.
Instead, we strongly believe that Congress should equip Medicare for the economic and health care challenges facing elderly Latinos and all seniors by eliminating the 24-month waiting period for Medicare after the award of disability benefits and enacting a catastrophic out-of-pocket limit. Additionally, counting all hospital observation days toward meeting eligibility for skilled nursing facility benefits; covering vision, dental and hearing services; and addressing underlying costs, particularly skyrocketing drug prices would ease the burden on elderly Latinos and all seniors.