News and Updates

A new fact sheet was developed by the Centers for Medicare and Medicaid Services (CMS)  with information for immigrant families and their healthcare providers to help them enroll for services when the ACA takes effect in January.

Currently, more than half of non-U.S. citizen adults are uninsured and immigrant children have much higher uninsured rates compared to children who are citizens. Lawfully present immigrants must wait five years in most states before becoming eligible for Medicaid. However, 22 states allow immigrant children with fewer than five years’ residency to enroll in Medicaid, and 18 states allow the same for pregnant immigrant women.

Expansions of coverage for lawfully present immigrants under the ACA include allowing naturalized citizens and legal immigrants who have lived in the U.S. for more than five years the same coverage opportunities as other Americans. Legal immigrants who have lived in the U.S. for fewer than five years will be able to purchase insurance in the exchanges and may be eligible for subsidies. Undocumented immigrants will not be able to enroll in Medicaid or to purchase coverage in the exchanges. The fact sheet includes a discussion on mixed-status families as well.

Outreach strategies are discussed in the fact sheet, including people to help with applications, translation, online enrollment and reassurance.

The National Council has further information here. For more resources on enrollment best practices, visit www.enrollamerica.org.

The National Center on Minority Health and Health Disparities, part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services (DHHS), released a Fact Sheet on Mental Health.

The fact sheet describes the history, the present and the future commitment to eliminating disparities in access to mental health care for racial and ethnic minorities.

The first section of the fact sheet describes the history of the Task Force on Black and Minority Health, which was established in 1984 to study health disparities, and the Surgeon General’s Report of 1999, which documented significant differences in access to mental health care and services for racial and ethnic minorities.

For the section dealing with current issues in disparities, the fact sheet details salient information such as the underlying factors that contribute to discrimination beyond socioeconomic status, including racial and gender biases. With the understanding that racial and ethnic minorities are the fastest growing demographic in the United States, this is more and more people who are failing to receive the help they need. A robust discussion of some of repercussions of the destruction of Hurricane Katrina on the mental health service capacity and lack of access for the ethnic populations in New Orleans follows.

The Fact Sheet wraps with a reiteration of the commitment by the NIH to reducing health disparities through research to develop treatment and prevention strategies.  

While the quality of health care in California has improved in recent years, "significant racial and ethnic disparities persist," according to a California HealthCare Foundation report, the California Health Care Almanac. The report was featured in an article posted October 10, 2013 in the California Healthline, a daily digest of health care news, policy and opinion at located online at californiahealthline.org. It indicates that while there has been improvement in care, there are still disparities in health care access and outcomes.

Outcomes Improve in California

The study found that rates of low birth weight were lower in California than in other states, at 6.8% compared with the national rate of 8.1% in 2011. Rates of pre-term births also were lower in California that year, at 9.8% compared with 11.7% nationally.

Meanwhile, 77.4% of California children were vaccinated in 2011, compared with 73.3% nationwide.

Disparities Remain

However, the maternal mortality rate among African-Americans in the state increased from 27.7 deaths per 100,000 live births in 1999 to 33.8 deaths per 100,000 live births in 2010.

The state's infant mortality rate for African-Americans was 9.5 deaths per 1,000 live births in 2010, compared with 4.7 deaths per 1,000 live births overall. For mixed-race infants, the mortality rate was 10.3 per 1,000 live births in 2010.

The study also found that in 2011:

• 19.8% of African-Americans in California had asthma before or during pregnancy, compared with 11.8% of whites and 6% of Latinos and Asian-Americans;
• 28.8% of African-Americans in the state were obese before or during pregnancy, compared with 26.5% of Latinos, 16.8% of whites and 6.8% of Asian-Americans; and
• 14.5% of African-Americans in California had hypertension before or during pregnancy, compared with a statewide average of 9.2%.

In 2010, African-American children in the state were more likely to visit an emergency department for asthma treatment than any other racial or ethnic group (Shinkman, Payers & Providers, 10/10).

In addition, the report found that nursing homes in the state performed well on a series of measures compared to such facilities across the U.S., including:

• Preventing falls;
• Weight loss; and
• Depression

However, California nursing home patients were more likely to be physically restrained than other facilities in the U.S.

Compared to the nation as a whole, California Medicare beneficiaries at the end of life were more likely to:

• Die in a hospital; and
• Have an ICU admission in the days preceding death (CHCF report, October 2013).