Health insurance costs can be a nightmare for small-business owners, and that’s a particular problem for Latinos, a federal health official said during a recent stop at the University of Kansas Medical Center in Kansas City, Kan.

Appearing as part of a panel discussing the Affordable Care Act and its implications for the Hispanic community, Mayra Alvarez said Wednesday that U.S. census data indicate Latinos are opening businesses at a rate that is three times higher than the national average.

The rub is that small-business owners traditionally have higher health care costs than their larger competitors, said Alvarez, director of public health policy in the Department of Health and Human Services Office of Health Reform.

“If you compare a small bodega (to a national chain) they often have to pay more,” Alvarez said. “They don’t have a risk pool to spread their risk among their employees, and now that small-business owner is saying, ‘Uh, if I have to pay this rate increase, I’m going to decide to not offer coverage or perhaps not hire a new employee that I would’ve wanted to hire.’”

A bodega is a convenience store that caters to Latino customers.

The health care reform law attempts to tackle the insurance problem by providing tax credits to small-business owners to help defray health care costs, Alvarez said.

According to 2010 census data, Hispanics comprise 10.5 percent of the population in Kansas. But in Wyandotte County, the figure is more than double the state average at 26.4 percent.

The numbers are even higher in the meatpacking and agricultural hubs of southwest Kansas. In Seward County, for example, Hispanics comprise nearly 60 percent of the population. And in Finney County, that figure is 46.7 percent.

Along with the Kansas City regional office of the U.S. Department of Health and Human Services, KU Med sponsored the panel discussion through its Department of Family Medicine and its Juntos Center for Advancing Latino Health. Other panelists were Dr. Joshua Freeman, chairman of the Family Medicine Department, and Mary Lou Jaramillo, chief executive officer of El Centro Inc., a community services provider in Kansas City, Kan.

Alvarez said the health care reform law has so far provided $11 billion to community health centers that serve the uninsured.

With a proportionally high number of young adults, Freeman said Hispanics in particular need expanded access to services for pregnant mothers and small children.

Freeman also noted the need for the health care reform act to improve nutrition in areas like the Argentine neighborhood in Kansas City, Kan., home to a large Hispanic community. For Argentine residents, he said, it might be quicker to walk to the nearest supermarket in neighboring Roeland Park than to ride the bus.
Alvarez said the community transformation grants available through the Affordable Care Act attempt to address transportation and other needs that have a direct bearing on the health of a community.

“Our families don’t put health care in a silo,” she said.

But the Latino community does not speak with one voice on the health care reform law, Jaramillo said.
Citing a 2011 poll of Latino voters, conducted for the Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico, she said 60 percent of the respondents opposed the mandatory purchase of health coverage included in the law. The poll also found that 29 percent of Latino voters supported repealing the law.

Jaramillo shared some of that skepticism.

“From our perspective at El Centro, and what I hear from our staff every day, I have this question,” she said. “Will this really happen? Will the health disparities that Latinos face be reduced?”