On the edge without a net

High number of uninsured Hispanics strains economy, families

Myriam and Ruben Balaguer, in the front yard of their home in the Animas Valley, discuss their plight without health insurance. Enlarge photo

SHAUN STANLEY/Durango Herald

Myriam and Ruben Balaguer, in the front yard of their home in the Animas Valley, discuss their plight without health insurance.

Two years ago, doctors told Myriam Balaguer she needed immediate hip surgery.

Lacking health insurance, she never had the operation and has lived in pain every day since.

Her husband, Ruben, a substitute teacher in Durango, worries about her often.

“She can’t walk for long distances, and she has a lot of pain,” Ruben Balaguer said. When medical attention is necessary, “it’s very hard because it costs a lot of money.”

The Balaguers are among 41 percent of Colorado Hispanics who live without health insurance. Nationwide, nearly 31 percent of Hispanics are uninsured.

Those numbers have serious implications because of the important roles Hispanics play in the economy, advocates say.

And the problem is worse in Colorado, where state and local economic-development officials say economic and educational disparities also are greater than the national average.

The problem’s causes

“There are a host of access-related issues we see playing out,” said Cara James, director at Disparities Policy Project at Kaiser Family Foundation, a nonpartisan, nonadvocacy organization based in California.

The issues preventing the growing ethnic group from obtaining insurance are many. They range from language barriers and citizenship challenges to discriminatory insurance practices, James said.

The Balaguers both work multiple part-time jobs that don’t offer insurance, and private health insurance is too expensive.

“Even the cheapest insurance is still too high for us,” Ruben Balaguer said.

One 32-year-old immigrant mother in Durango said she also cannot afford private health insurance, and being undocumented keeps her from joining the more than 20 percent of the state’s residents getting help from Medicaid.

“We’re human beings; help should be available and people shouldn’t be treated differently when it comes to their health and health care,” the mother, who declined to be identified, said through a translator.

Others said fear of deportation keeps them from even trying to find help.

State officials estimate there are approximately 21,000 children in the state who are undocumented and uninsured – despite the many initiatives attempting to reach them.

While access to health care and health insurance is likely to remain restricted for undocumented residents, James said national health-care reform takes “important steps in the right direction.”

The reform’s expansion of Medicaid benefits, health-insurance exchanges, tax credits for small businesses to provide health insurance and high-risk pools are expected to bring coverage to more of the Latino community. The reform also mandated that ethnic disparities among the uninsured be studied and addressed.

The reform’s gains could be reversed, though.

“Given what is happening politically and in the courts, it remains to be seen what will be implemented in the end,” James said.

Other hurdles

Durango’s high cost of living and low wages provide an added dimension of hardship for area minorities.

And employers’ hands often tied. More than 86 percent of La Plata County’s businesses have fewer than 10 employees, according to Region 9 Economic Development District of Southwest Colorado. For them, group health insurance is costly and sometimes impossible to provide.

Even with insurance, co-pays alone can outstrip many local Latinos’ budgets, program officials with the Family Center of Durango and the Women’s Resource Center.

Durango’s isolated location and small population also don’t help, said Joanne Zahora, spokeswoman for Colorado Department of Health Care Policy and Financing. This makes it harder to access government money for subsidized clinics, she said. In fact, Axis Health recently lost a bid to become a federally qualified health center.

Eve Presler, director of Advocacy for La Plata, an organization that assists at-risk families, said some must drive for hours to reach subsidized services.

“For one client this week, a young mother with a newborn, I had to fund an $800 car repair so she could get an emergency wisdom-tooth extraction in Grand Junction,” Presler said.

Even gaining a better understanding of the problem in our community is challenging because few solid figures exist, local officials said.

Advocates are working to address the most glaring problems, including a lack of low-cost dental providers and language barriers. But they say they’re fast losing ground as the economic downturn drags on and their agencies are peppered with funding cuts at every turn.

“The resources are not keeping up with the needs,” Presler said.

On the chopping block

Already, Colorado has been forced to scale back its Medicaid program for adults without children. Officials recently announced only 10,000 Coloradans earning less than $1,100 per year will be able to access Medicaid between now and 2014, when more federal money is expected to be available.

And a grant for the interpreter program though the La Plata Unity Project, a collaboration of area organizations working on immigrant issues, runs out next summer, said Danny Quinlan, immigrant outreach and volunteer interpreter coordinator. It’s key to health care and insurance access for Spanish-speaking families in the area.

Funding cuts also are stripping direct services at San Juan Basin Health Department – a critical resource for the area’s Hispanic community, said Patsy Ford, director of the personal health division. The agency is in the process of eliminating Personal Care Provider (PCP) and prenatal services, affecting 193 PCP clients and 53 prenatal patients. Nearly 40 percent of the agency’s clients in La Plata and Archuleta counties are Hispanic and about 75 percent of those people speak only Spanish and are unable to obtain subsidized health insurance.

“The cuts really tie our hands,” Ford said.


Ruben Balaguer examines his garden in the front yard of his home in the Animas Valley. Ruben and his wife, Myriam, are without health insurance. Enlarge photo

SHAUN STANLEY/Durango Herald

Ruben Balaguer examines his garden in the front yard of his home in the Animas Valley. Ruben and his wife, Myriam, are without health insurance.

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