Health care reform will provide coverage to countless uninsured and underinsured Asian Americans, Native Hawaiians, and Pacific Islanders (AAs and NHPIs). More than one in six Asian Americans and one in five Native Hawaiians and Pacific Islanders are uninsured. An expanded Medicaid program, new Health Insurance Exchanges, the Pre-existing Condition Insurance Plan (also known as the High Risk Pools), the Small Business Health Options Program Exchange, and the extension of coverage for young adults to remain on their parent’s health plan until age 26, offers our communities new options for affordable quality care. Most Americans get their health coverage through their employer. AAs and NHPIs are less likely to have employer-sponsored coverage compared to non-Hispanic Whites, and are more likely to be uninsured. Native Hawaiians and Pacific Islanders are more likely to be uninsured and more likely to be on Medicaid than both Asians and non-Hispanic Whites. There is wide variation in health coverage among AA and NHPI ethnic subgroups, which correlates with type of employment. Employer coverage rates range from as low as 49 percent among Koreans, almost two-thirds of whom work in small businesses, to a high of 77 percent among Asian Indians.
Beginning in 2014, Medicaid expanded to cover eligible children and families with incomes at or below 133 percent of the Federal Poverty Level, including childless adults. Currently, nearly one in 10 Asian Americans and one in four Native Hawaiians and Pacific Islanders are enrolled in Medicaid. Nearly half of the current uninsured population, or 21 million people, would be eligible for coverage under this expansion. It is difficult to estimate how many AAs and NHPIs would be newly eligible for Medicaid, but the expansion is expected to provide the largest increase in the number of people with health insurance than any other coverage expansion measure in the law. In California alone, it is estimated that over 140,000 Asian Americans, Native Hawaiians, and Pacific Islanders would be eligible for coverage under an expanded Medi-Cal program (the state’s Medicaid program).
Each state will create its own Health Insurance Exchange (HIE), or the federal government will operate one for them. The HIE will serve as a one-stop marketplace for purchasing insurance coverage, with all plans containing an “Essential Benefits Package,” which sets the minimum benefits to be provided. individuals and families with incomes between 133 and 400 percent of the Federal Poverty Level will be eligible for subsidies to buy health insurance in the Exchange. Nearly one in five families who are currently uninsured will be eligible for subsidies in the Exchange.
Health care reform established the Pre-existing Condition Insurance Plan (also known as the High-Risk Pools). Prior to health care reform, insurance companies could deny health coverage to individuals with pre-existing conditions. Now, insurance companies are prohibited from this type of discrimination, allowing individuals living with chronic conditions to access the life-saving testing and treatment services that have been inaccessible to them in the past.
Many small businesses struggle to provide health coverage for their employees. More than three-quarters of small business employees in businesses with less than 100 workers are currently uninsured. Small businesses with up to 100 employees will be able to buy health coverage through a state-based Small Business Health Options Program (SHOP) Exchange. The SHOP Exchange will offer better health coverage options at a lower price for small businesses than what is currently available. Nearly 18 million small business employees could gain coverage through the SHOP Exchange.
Under health care reform, parents can elect to keep their young adult children on their health plans until age 26. Before health care reform, adult children could be kicked off their parent’s health plan at age 19 (older if the child was a full-time student). Currently, nearly one in four Asian American and three in ten Native Hawaiian and Pacific Islander young adults (18-24 year olds) are uninsured. More than 300,000 AA and NHPI young adults could gain insurance under this reform.