Thursday, January 12, 2017

How the AAPI community will be impacted if Republicans eliminate the Affordable Care Act


THE AFFORDABLE CARE ACT was pitched as a moonshot by President Obama in 2009. Since the official institution of the Patient Protection and Affordable Care Act (ACA) in 2010, many previously marginalized groups in healthcare have received access to health care insurance. Now, President-elect Donald Trump heads for office this January 20, after campaigning for a starkly opposite vision. 

The ACA - sometimes referred to as Obamacare - appears to be the first of several Democratic-instituted programs Trump will repeal. So what does this mean for Asian/Americans and Pacific Islanders?

A lot is at stake. According to the U.S. Census Bureau, between the years 2008 to 2014, Asians represented the highest rate of enrollment in health insurance purchases. The CDC National Health Survey shows comparable trends. Between 2013 and 2015, the percentage of Asian/Americans who were non-insured decreased from 16.1 percent to 8.8 percent; almost halving the percentage of uninsured. These drastic numerical changes coincide ACA’s enactment.

According to statistics provided by the White House in 2014, 1 in 4 Korean/Americans and 1 in 5 Vietnamese/Americans lacked insurance. The US Department of Healthcare and Human Services cites that Asian/Americans are an unlikely group to be screened for cancer. For example, in 2010, Asian/American women were the least likely population to have had a Pap smear. Furthermore, Asian/Americans and Pacific Islanders ranging from 19 to 24 in age were 1.6 times more likely to have Hepatitis B than non-Hispanic Whites.

When seeking healthcare, Asian Americans face issues comparable to many immigrants and lower-income patients. The lack of comprehension, fear of the system and the inaccessibility of hospitals are all barriers to entry for these populations. 

Asians, in particular, face another edge of the “model minority” sword: the population ranks among the fastest-growing populations in poverty since the Great Recession. Moreover, because Asian/Americans typically either work for or run small private businesses, health benefits are rare.

Theresa Lau, author of an opinion article on NBC news recalls 15-mile drives and waiting hours to see a community health specialist for her care. With non-English speaking parents who worked long hours for limited income, a doctor’s visit was atypical and difficult. Lau’s dismay at the potential repeal of the ACA reflects an opinion many may share. Since the ACA’s implementation in 2010, around 20 million new patients have been insured.

The outlook for continuation of the ACA looks to be grim. Trump has already nominated Seema Verma as the Administrator of the Centers for Medicare and Medicaid Services and Tom Price as Health and Human Services Secretary.

Verma is known as a staunch Republican. Her work with Indiana Governor Mitch Daniels advocated for low-income patients to compensate for their insurance by volunteering, and contributing to a health payment account. Price is known for drafting an alternate, GOP rendition of the ACA, the Empowering Patients First Act or EPFA. The alternative proposes offers tax credits so patients may purchase insurance through the private market. Together, the decisions of Trump, Verma, and Price will change the health landscape of millions of Americans, marginalized and not.