Addressing Racism and Discrimination to Improve Health

Outcomes in Immigrants and Communities of Color

Betzabel EstudilloHealth Policy Coordinator California Immigrant Policy Center

Founded in 1996, CIPC is a non-partisan, non- profit statewide organization that seeks to inform public debate and policy decisions on issues affecting the state’s immigrants and their families in order to improve the quality of life for all Californians. CIPC engages in policy advocacy, and also provides technical assistance, training and education on immigrant issues.

A Historic Look at Healthcare for People of Color

• Hippocrates – Race and Biological Differences• Racism and Discrimination in Health Care in US

• Experimentation and Treatment of Slaves • Post-Slavery to the Modern Era: Lack of

Healthcare for New Citizens and Poor Whites • Experimentation on Communities of Color • Impact on Immigration Policy

Racism and Discrimination in US Healthcare System

• Health status related to where you live• Barriers to hospitals and access to quality of

care • Racial disparities in medical treatment • Lack of data and standardized collection

methods • Lack of economic access to healthcare

How do disparities impact people?

• The Case of Two Baltimore Neighborhoods – Little Italy and Canton• Kids born in Little Italy are more than 10 times

as likely to die before their first birthday as those born in Canton

• In Baltimore's Little Italy neighborhood, about two out of every 100 children die before their first birthday — which puts infant mortality in Little Italy roughly on par with Nicaragua and Uzbekistan

California Life Expectancy

The Promise of The Affordable Care Act

• Increased healthcare for communities of color in California • POC 60% of CA population, but 75% of the

uninsured post-ACA • Of the Nearly 1.5 elderly adults to be newly

eligible for Medi-Cal, 2 out of 3 are POC • Standardizing Health Benefits • Banning Pre-existing condition exclusion

Source: CPEHN

The Failings of the Affordable Care Act

• Not universal healthcare • Specifically excludes undocumented

immigrants• Access to providers continues to be

problematic • Reduction in funding to community clinics

and safety next structures • Continuation of health disparities

Why health equity matters?

• Income is a better predictor of poor health • Nationally and CA institutional racism in the

form of • housing segregation• employment discrimination• unequal wages and other discriminatory practices

• Has created persistent inequalities that lead to poorer health outcomes and limit opportunities for communities of color

How do we address health disparities?

• Medicaid and Medicare for All • Expanding health insurance coverage- health4all

at the state and federal level • Increase State/Federal Funding to Safety-Net Providers

(Clinics/DSH)• Improving the capacity and number of providers in

underserved communities• Data on race, ethnicity, and language access is

important!• Address racism, white privilege, white supremacy

Health4All: Breaking Down Barriers to Healthcare for All

California Residents

California Takes Steps to Integrate Immigrants

• Driver’s Licenses – AB 60 (Alejo), 2013

• TRUST Act – AB 4 (Ammiano), 2013

• Professional Licenses SB 1159 (Lara), 2014 and State Bar Dream Act AB 1024 (Gonzalez, 2013)

• Protections for Workers – Anti-Retaliation, E-Verify

• Full Scope Medicaid for All Low-Income Lawfully Present Immigrants

• Expand full-scope Medicaid to undocumented children

HEALTH4ALL IN CALIFORNIA

Why is Health4All important?

Though the state provides health care services through programs with limited scope or duration, and some counties provide coverage regardless of immigration status, it is not enough.o Health Care system works better when everyone participates o Emergency room treatment is expensiveo Everyone deserves comprehensive and adequate care o Healthy Parents, Thriving Families o Undocumented immigrants are a major economic engine for

California, and contribute to the state’s revenueo Health is a Human Right

Undocumented Californians and Health Access

• The Affordable Care Act (ACA) has expanded health coverage to millions of Californians

• Remaining Uninsured• UC Berkeley Labor Center study- After the full implementation

of the ACA, there will be 2.7-3.4 million Californians who will remain uninsured

• About 1.4-1.5 million will be undocumented Californians

• Access“Band Aid” Care• Patchwork of County coverage for the undocumented. • Some counties offer coverage, other counties don’t offer any

coverage, and some offer limited scope or duration coverage.• Emergency and charity care

SB 4 (Lara)

First introduced By Senator Ricardo Lara in 2014 as SB 1005 Re-introduced in December 2014 by Senator Ricardo Lara The proposal will ensures that undocumented children in our

communities has access to quality and affordable healthcare Coalition Building: Diverse coalition of immigrant rights groups,

health and consumer advocates, labor, and many others

Signed by Governor Brown on October 9, 2015!

Pro-Immigrant Investments in 2015-2016 Budget

The 2015-2016 state budget included exciting and historic package of investments that will help lift up our immigrant communities.

In regards to immigrant health, this year’s budget lays the foundation for improving access to health for immigrant communities by:

Investing an initial $40 million and an ongoing commitment to expand access to Medi-Cal for undocumented children, regardless of immigration status.

Next Steps on Health4All

SB 10 Seeks to allow undocumented adults to receive comprehensive Medi-

Cal, if funding is made available. Allow all Californians, regardless of immigration status, to purchase

coverage through Covered California with their own money by requiring the state to apply for a federal Section 1332 waiver (a formal request to the federal government).

County safety-net advocacy for undocumented residents

Continue to uplift immigrant voices and engage community in health4all efforts

What can you do to help advance policies

that benefit immigrants and other

communities of color?

• Fight for Health4all!• Support Efforts to Fight: Racial Profiling,

Excesive Use of Force, and Unjust Detention and Deportation

• Support State Funding to CBO’s that offer Immigration Services to Assist those Eligible for Deferrred Action

• Support Efforts to Invest Resources in the Safety Net

How do we move forward and ensure positive health outcomes for all?

• Break down the System Founded on White Supremacy

• Check your privilege – (White, English Speaker, Educational Attainment, Income, Profession)

• Call out friends that need to see these issues through a more progressive lens

• Value the Health and Safety of All

Betzabel Estudillo

California Immigrant Policy Centerbestudillo@caimmigrant.org