Transcript Document

Merced
Healthcare
Consortium
October 23, 2014
Merced
Healthcare for
the Remaining
Uninsured
Marisol Aviña
Marlon Cuellar
The California Endowment
Who are the Remaining Uninsured?
• 1.4-1.5 million unauthorized and uninsured Californians—
previously 20% of the uninsured, will compose almost 50%
of the remaining uninsured.
• Majority of remaining uninsured will be citizens or legal
residents
• Some frozen between “open enrollment” periods
• Affordability issues: e.g., workers with employer-based
coverage for themselves but not family, choose not to enroll
• Immigrants and communities of color:
– Disproportionately benefit from coverage expansion
– Disproportionately part of the remaining uninsured
Beyond Obamacare
• We must use this window to find a statewide
solution for access to care and services for the
undocumented and remaining uninsured.
• Major public education campaign on the necessity
for at least preventive services for everyone in
California
#Health4All Campaign
• Communications
• Research
• Local & State: Capacity and
Coalition Building
• Federal: Federal Immigration
Reform
Communications
Messaging
• Prevention Makes Economic Sense: Emergency room treatment is
an expensive substitute for preventive care. It makes economic
sense to invest in preventive services that minimize the risk of
chronic disease and more costly treatment later on.
• Access to health care is a basic human right and increasing access
is the Right Thing to do: Everyone—regardless of ability to pay or
legal status—should have access to affordable health care.
• Undocumented Californians are part of the fabric of our
communities. They are our neighbors, friends, co-workers, and an
integral part of our communities. They pay $2.7 billion in taxes
every year. This includes sales and property taxes that fund
schools, public safety, infrastructure, and other vital services. It’s
only fair to expand access to include all California taxpayers
regardless of immigration status.
Social Media
Bus Ads
TV Ads: I am California
Newspaper Ads
Community
Billboards
Other Resources and Engagement
• Integrating proper messaging for this population in
our enrollment events
• Creating consumer friendly FAQ in Spanish and
English
• Eligibility Grid
• Statewide Direct Mail
• Activation/Support Cards
• #Health4All listserve
#Health4All
15
Research
17
Additional research
• UCLA Labor Center /Dream Resource Project statewide survey
led by immigrant youth
– Over 500 surveys
– Preliminary results: many immigrant youth don’t have health insurance, many
rely on community clinics, many have translated for family members in order to
access care
• USC/Manuel Pastor
– Will generate estimates and information regarding the number and characteristics
of the unauthorized migrants residing in TCE's 14 Healthy Communities.
• UC Berkeley/Blue Shield Foundation study on DACA eligible
population & health needs
• Opinion Research – Voter Polls
State & Local
Capacity and
Coalition
Building
Capacity and Coalition Building
• Identify areas of collaboration and partnership
between coalitions that could advance immigrant
health at the local level and plug into statewide
advocacy work
• Strengthen capacity of coalitions to engage in local
campaigns through local sub-grants.
• Grassroots outreach through California Calls
• Youth engagement – Pre-Health Dreamers
Federal
Federal Immigration Reform: National
Immigration Law Center
Goals:
• Educate policymakers and advocate for federal
immigration reform policies that allow aspiring citizens to
have the same access to safety net programs, public
services and economic supports as other lawfully present
immigrants.
• Research and explore options for policies needed to help
providers and localities protect and strengthen the safety
net in California to ensure that undocumented
immigrants and others left without affordable coverage
to continue to have access to basic, affordable, nonemergency care.
Options to Addressing CA’s Remaining
Uninsured & Undocumented
• Status of statewide policy efforts
• County - There is a successful track record for
allowing underinsured and uninsured residents
eligibility and full access to preventive health
services and health homes through LIHP-like
programs.
Voter Poll
California Voter Support for Providing
Health Coverage for All
• 800 telephone interviews with registered voters statewide
– Oversample of an additional 154 African-American voters, with data
statistically weighted to reflect the true ethnic composition of the
electorate
– Interviews conducted August 24-31, 2014
– Interviews in English and Spanish and on landlines and wireless phones
• Margin of sampling error of +/- 3.5%
• Central Valley data is 8 counties and 84 interviews, margin of
error is 11%
• Bipartisan research team of Fairbank, Maslin, Maullin, Metz
& Associates (FM3) (D) and GS Strategy Group (R)
Policy Description Tested
As you may know, federal health care reform – also known as
Obamacare – was signed into law. As a result, a new state program
called Covered California now offers individuals affordable private
health care coverage for purchase, and also offers discounted
rates to those who cannot afford to pay. In addition, Medi-Cal was
expanded to cover over one million Californians who didn’t
previously qualify. However, millions of Californians still are not
offered health coverage through these changes – including
undocumented immigrants.
Currently, health care providers are required by law to provide
emergency care to all Californians, including those who are
undocumented, whether or not they have health insurance
coverage. The costs of this care are currently passed on to other
patients and taxpayers.
Most Californians in the state support
the policy.
To prevent costly emergency care, some people have proposed expanding access to
affordable health coverage through Medi-Cal and Covered California to cover all lowincome Californians – including those not currently eligible because of their immigration
status. Does this proposal sound like something you would support or oppose?
State
Central Valley
25%
Total Support
44%
19%
18%
34%
4%
Total Oppose
52%
For many, support is guided by a conviction
that it’s the “right thing to do.”
State
Central Valley
Increasing access to health care
is the right thing to do. No one
should suffer or die from a
condition that can be treated
just because of their…
49%
60%
We should not provide any
publicly-funded healthcare
benefits to tax-paying
undocumented immigrants
28%
Both/Neither/DK/NA
39%
14%
0%
15%
12%
30%
45%
60%
75%
Central Valley voters support various
elements and impacts of the policy.
Total Support:
Improving access to preventive care to reduce overall health
costs and prevent the spread of disease
Total
Oppose:
75%
Ensuring that working undocumented immigrants have the
ability to purchase affordable health insurance
68%
19%
30%
Reducing the costs paid by patients and taxpayers to cover
unpaid emergency room care for the uninsured
55%
36%
Expanding the state’s Medi-Cal health care program for lowincome residents to provide preventive health services to
undocumented residents who are not eligible for coverage
under the current health care law
Ensuring that working, uninsured undocumented immigrants
can be eligible for subsidized health coverage through
Covered California
54%
31%
43%
50%
Pro and Con Messages Tested
Supporters say access to health care is a basic
human right, and our economy and
communities are stronger when everyone has
health coverage. When people lack health
coverage, they wait to get treated until their
condition worsens and requires expensive
emergency care. That’s passed on to the rest of
us in a “hidden tax” of lowered productivity and
higher medical expenses. In contrast, when
people have access to preventive care like
vaccines and annual checkups, they avoid
expensive illness later on and are more
productive on the job. It’s more cost-effective to
make sure that ALL Californians have basic
access to doctors, hospitals and health clinics,
than to wait to treat them after they become
sick.
Opponents say that extending
health coverage to those here
illegally will force California to raise
taxes, meaning more jobs leaving
the state and more costs for all of
us. Undocumented immigrants are
breaking the law and should not be
rewarded. Besides, the existing
health care system is broken—there
is a doctor shortage, emergency
rooms are crowded, and health care
costs continue to rise. The system
should work first for those who have
legal status before expanding it to
others.
Messaging Moves Voters
70%
63%
60%
50%
40%
54%
52%
44%
41%
55%
41%
56%
51%
44%
40%
34%
30%
20%
10%
5%
4%
0%
Initial Support
4%
3%
After Positive
Message
5%
3%
After Negative
Message
Total State
Support
Total State
Oppose
Total state
undecided
Total CV
Support
Total CV
Oppose
Total CV
undecided
Conclusions
• While Central Valley voters do not instinctively
support the policy, when context and information is
provided, they become more comfortable with the
idea.
• Broad bipartisan consensus in favor of improving
access to preventive care.
• The numbers are encouraging – with the right
framing and messaging, voters across the political
spectrum can be moved.
Join the conversation
• Health4all list serve
– www.health4all.org
• Follow us on Facebook
– https://www.facebook.com/CalEndow
Follow us on Twitter
– https://twitter.com/CalEndow
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– http://instagram.com/CalEndow
Marisol Aviña
Marlon Cuellar
Program Managers,
Healthy California
The California
Endowment
Email:
[email protected]
[email protected]
Phone:
916.558.6780
916.558.6764