New Survey Finds New York Latina Women Obtain Public Health Insurance More Easily Than Those in California, Florida

NEW YORK CITY, Dec. 5 - Latina women who apply for public health insurance in New York face far fewer immigration-related fears and administrative obstacles than their counterparts in California and Florida, according to a two-year study released today by The New York Academy of Medicine and the University of California, San Francisco.

One in 10 pregnant Latinas in New York (or 9%) reported experiencing "problems or fears" when applying for Medicaid, according to the study. The climate of fear was significantly more intense in San Francisco, where a staggering 1 in 2 (or 55%) of new Latina mothers reported "problems or fears," and in Miami, where 1 in 3 (or 33%) reported such barriers. The study surveyed 2,370 Latinas in New York City, San Francisco and Miami who had recently given birth.

The findings spotlight both New York's success and the need for improvements in California and Florida, such as simplification of the application process and better education of Latinas regarding the immigration-related risks (or lack thereof) when applying for public insurance. Although Latinos account for only 12 percent of the total U.S. population, they make up one-fourth of the nation's 41 million uninsured residents. A mother's lack of health insurance often results in inadequate care for the entire family.

"Other states should look to New York as a model for helping more immigrant women gain access to health insurance coverage," said lead researcher Tamar Bauer, JD, director of The New York Forum for Child Health at The New York Academy of Medicine. The report, entitled "Challenges Associated with Applying for Health Insurance Among Latina Mothers in California, Florida and New York," describes several positive steps taken by New York.

When the federal government stripped undocumented pregnant immigrants of their Medicaid eligibility under its new welfare law in 2001, New York earmarked state funds in order to maintain the women's coverage.

Unlike California, New York has not created blatant anti-immigrant policies. California adopted "Proposition 187" in 1994 and other antagonistic directive that created difficulties for immigrants who had used public benefits. These programs were repealed in 1999 but a climate of fear remains.

Since 1990, New York has offered a streamlined application process for pregnant women seeking Medicaid. Through the "Prenatal Care Assistance Program" (PCAP), women can sign up for Medicaid by completing a simple form at their prenatal care provider's office. No social security number is required. "New York's efforts at streamlining the application process have helped pregnant women get the coverage to which they are entitled," Bauer said. "But there is still room for improvement. Enrollment should be simplified for all immigrants, using PCAP as a model. Many children and adults who are eligible for public coverage are still not enrolled, in part because the procedure is just too complex."

The severity of problems that pregnant Latinas face when seeking insurance varies among the states. In New York and Florida, women were more likely to cite procedural issues - such as confusion about the application process or lack of necessary paperwork - than immigration-related fears. Concerns about being asked for a social security number were highest among California Latinas. California women were also more afraid that applying for public health insurance would derail their chances at citizenship, which is untrue, and that they would have to pay back the costs of care someday, which is no longer true since California eliminated its recoupment programs. (Sponsors of immigrant women may in fact be required to repay the expenditures at some point in the future, under not-yet-implemented provisions of the 1996 federal welfare law). Even U.S. citizens and people who are legally in this country reported encountering barriers to securing public health insurance, though less in New York than in California and Florida.

"Clearly, a massive education campaign is needed to build trust and confidence among Latina immigrants, especially in California, where the legacy of an anti-immigrant policy climate in the 1990s still lingers," said study author Elena Fuentes-Afflick, MD, MPH, of the Department of Pediatrics at UC-San Francisco.

This research was supported by grants from the Health Resources and Services Administration, New York Community Trust, William T. Grant Foundation, March of Dimes Birth Defects Foundation/Greater New York Chapter, Maimonides Research Foundation, David and Lucile Packard Foundation, and the Health Foundation of South Florida. Howard Minkoff, M.D., Chair of Obstetrics and Gynecology at Maimonides Medical Center in Brooklyn, N.Y., is the principal investigator for the study. The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on urban populations, especially the disadvantaged.

Read the PDF of the Policy Brief and the Full Report.

Read Media Coverage:

• Packard Foundation Newsletter
• San Francisco Chronicle
• Santa Cruz Sentinel

Posted on December 5, 2002

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Contact:
Andrew J. Martin
Director of Communications
The New York Academy of Medicine
1216 Fifth Avenue
New York, New York 10029
212-822-7285
amartin@nyam.org

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