How the Supreme Court's Health Reform Ruling May Affect the Latino Population
This is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Gabriel R. Sanchez, PhD, is an associate professor of political science at the University of New Mexico, assistant director of the RWJF Center for Health Policy at the University of New Mexico, and director of Research for Latino Decisions.
The Supreme Court decision regarding the constitutionally of the signature policy victory of the Obama administration has been the most anticipated and hotly debated decision of the Court in recent memory. In the spirit of a prior Human Capital blog post I wrote back in November, I wanted to take advantage of the opportunity to participate in this series by providing a perspective on how this decision will likely impact the Latino population. I have been analyzing public opinion toward health care reform for some time now, and draw on some of this data to provide a few examples. I focus my attention here on some of the more intriguing relationships to emphasize the complexity of Latino’s views of this historic policy.
Latinos had a lot at stake in this decision, as the Affordable Care Act (ACA) is projected to expand insurance to 9 million Latinos. It is therefore not surprising that support for health care reform, and the ACA in particular, has been higher among Latinos when compared to non-Latinos. In fact, since Latino Decisions started collecting data in October 2011, on average 51 percent of Latinos have supported the ACA. Conversely, as reflected in the figure below, the percentage of Latino voters who want to repeal the law has been lower than what other polls have shown for the non-Latino population over this time period.
It is important to note that survey questions we utilize to gauge support for expansion of health coverage often cue voters to consider that providing more Americans with health insurance could mean an increase in their personal taxes. For example, below are the results from a question posed in a 2009 Latino Decisions/UNM-RWJF Center/impreMedia survey which asked respondents: “Do you think the Federal government should ensure that all people have health insurance, even if it means raising taxes, or do you think we should continue with the current health care system?” As depicted in the figure below, more than twice as many Latino registered voters would prefer to see increased taxes to ensure that all Americans have health insurance than to continue with the current system. This implies that Latino voters understand that expanding access to coverage will result in higher taxes.
As noted in my prior Human Capital blog post, survey research focused on Latinos must pay attention to potential differences in attitudes within diverse communities, including Latinos. This potential variation in policy attitudes within the Latino community is most evident when we look at support levels for the ACA by nativity. In a January, 2012 Latino Decisions/Univision News survey, we found that only 21 percent of foreign-born naturalized Latino citizens felt that the ACA should be repealed compared to 34 percent among the native-born population. This is an intuitive finding that some would argue is based on underlying self-interest, as foreign-born Latinos are less likely to have access to insurance.
Things become more complicated however when we focus our attention to attitudes toward the individual mandate. Here, we see that sub-groups of Latinos that we might view as winners following the recent Court’s decision do not necessarily see it that way. For example, the ACA allows children to remain covered through their parent’s plan through age 26. Latinos are significantly younger than the general population—31.3 percent of Latino citizens were between the ages of 18 and 29, compared to only 19.2 percent of whites—which leads to a higher ratio of expanded coverage for Latinos than non-Latinos due to this aspect of the larger law. Researchers from the Health and Human Services Department estimate that over 700,000 Latinos now have health insurance because of this provision. However, a June, 2011 survey conducted by Latino Decisions in collaboration with the Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico indicated that 34 percent of Latinos between 18 and 34 years of age believe that the law should be repealed, compared to 29 percent overall. This is an example of how important it is to explore internal variation within the Latino population, as attitudes can vary in important ways within communities toward public policies.
While I believe that data suggests that Latino voters’ reaction to the Supreme Court’s decision is on the whole positive, this post points out that Latino’s views toward the ACA are complex and varied.
If the law is successful in expanding access to insurance to a wider segment of the population, while bringing down the bloated costs of care for many, I am confident that future survey work will show that Latinos will look back at this moment in history as a turning point in the battle to end health disparities facing their community.