More Californians than ever before have health insurance, but coverage isn’t care, and the Affordable Care Act (ACA) has magnified the deep racial, ethnic and cultural disparities in accessing quality health care in California.
Latino and African Americans especially remain heavily uninsured and struggle to receive health care.
Language and cultural barriers, lack of Internet or an email address, a lack of experience in using health insurance, a shortage of doctors and clinics in poor and rural communities, and high costs are preventing many from receiving health care and medications.
A new report “Breaking Barriers: Improving health insurance enrollment and access to health care in California,” reveals a deep divide between social class, income, culture and ethnicity emerging under the state’s Covered Care.
“It’s unconscionable that so many have been left out of something as basic as the chance to enjoy good health,” said Gary Delgado, author of Breaking Barriers. “Lack of Internet access or speaking another language is not a reason to be locked out of a health system that purports to be open to all.
“Obamacare did not cause the widespread racial disparities we found, but neither did it solve them. Now we have to take them on directly,” said Delgado.
“Breaking Barriers” is a year-long study that includes a survey of nearly 1,200 low-income people in 10 states in Spanish, Cantonese, and English. They were contacted at food banks, health clinics, and homeless centers.
Alfredo DeAvila did surveys and interviews for the Breaking Barriers California report.
“If the ACA is going to be successful, we need to help people transition not only into the health insurance system, but also into the health care system,” he said. “We must invest in public education about how to get ongoing preventive care.”
The Korean America community, especially seniors are struggling because of costs, said DJ Yoon, executive director of NAKASEC (National Korean American Service and Education Consortium.)
“California can be a leader in assuring quality health care for all people. We have let people of color again slip through the cracks in our system, we can do better – and here is a roadmap for how we get there,” said Delgado.
Key recommendations in the report include:
Improve language access. Make provider directories available in multiple languages and list addresses, phone numbers, languages spoken, hospital affiliations, and specialties;
Simplify the insurance-shopping experience. Make cost information transparent and communicate clearly about deductibles, co-pays, and preventive services that are included;
Covered California should enforce and impose penalties on insurers who do not reduce racial health care disparities within required timeframes;
Assure that primary care providers are within 30 minutes driving or public transit time. Enrollees who must travel further should be offered free transportation;
Expand school-based health centers, especially in medically underserved communities;
Address underlying causes of poor health, especially in poor communities, (mold, infestations, domestic violence) Expand medical-legal partnerships as an avenue toward addressing poor health in low-income communities;
Reinforce the ACA-mandated “well-woman preventive” care and provide education about the value of preventive care for all. Ensure that all plans include reproductive health care services.
The full Breaking Barriers in California report is available at http://allianceforajustsociety.org/wp-content/uploads/2015/04/BBReport_CALIF.pdf