The Reality of Medicaid Enrollment and usage

Medicaid, along with the Children’s Health Insurance Program (CHIP), forms a critical part of the national safety net, providing healthcare coverage to approximately 80 million people. While enrollment saw increases following the implementation of the Affordable Care Act and the onset of the COVID-19 pandemic, it began to decline during the latter years of the Biden administration.

The impact of immigrants on the healthcare system is often overstated in political discourse. As an example,Vice President JD Vance stated during a campaign event last year that “we’re bankrupting a lot of hospitals by forcing these hospitals to provide care for people who don’t have the legal right to be in our country.” This statement was rated “False” by PolitiFact.

To address these misconceptions, KFF health News, in collaboration with Factchequeado, has analyzed five common myths circulating on social media, consulting with experts to provide accurate details.

Myth 1: Do Latinos Who Receive Medicaid Work?

The assertion that Latinos on Medicaid are not employed is largely untrue. According to a KFF analysis of Medicaid data, almost 67% of Latinos enrolled in Medicaid are employed. Jennifer Tolbert, deputy director of KFF’s program on Medicaid and the uninsured, noted that this is “a higher share of Medicaid adults who are working compared to other racial and ethnic groups.”

For many low-income people, the myth is that thay are not working, even though we certainly know from a lot of data that many people work but don’t have access to affordable employer-sponsored insurance.
Timothy McBride, co-director at the Center for Advancing Health Services, Policy and Economics Research, part of the Institute for Public Health at Washington University in St. louis.

myth 2: Are Latinos the Largest Group Enrolled in Medicaid?

Contrary to popular belief, Latinos are not the largest demographic group enrolled in Medicaid and CHIP.Data from a CMS document reveals that non-Hispanic White individuals constitute the largest share of enrollment at 42%,followed by Latinos at 28%,and non-Hispanic Black individuals at 18%,with smaller percentages representing other minority groups.

Gideon Lukens, research and data analysis director on the health policy team at the left-leaning Center on Budget and Policy Priorities, stated that Latinos’ share of total Medicaid enrollment “has remained fairly stable for many years — hovering between 26 and 30% since at least 2008.”

Alex Nowrasteh and Jerome Famularo of the libertarian Cato Institute, in a Feb. 18 blog post, addressed the broader issue of immigrant welfare use, stating: “The biggest myth in the debate over immigrant welfare use is that noncitizens — which includes illegal immigrants and those lawfully present on various temporary visas and green cards — disproportionately consume welfare. That is not the case.” They included Medicaid in their definition of “welfare.”

while Latinos are not the largest group they do represent the demographic with the highest percentage of their population enrolled in Medicaid. Of the approximately 65.2 million Hispanics in the U.S., representing 19.5% of the total population, about 31% are enrolled in Medicaid. This is often due to the fact that employed Latinos frequently hold jobs that do not offer affordable health insurance.

kelly whitener,associate professor of practice at the Center for Children and Families at Georgetown University’s McCourt School of Public Policy,emphasized that “Medicaid eligibility is not based on race or ethnicity,” but rather on factors such as income,age,pregnancy,or disability status,which vary by state.

Myth 3: Do Most Latinos Living in the Country Without Legal permission Use medicaid?

Federal law restricts Medicaid benefits for immigrants without legal status. These individuals are generally not eligible for federal Medicaid benefits.However, as of January, 14 states and the District of Columbia have allocated their own funds to extend coverage to children nonetheless of immigration status. Moreover, seven states and D.C. have expanded coverage to some adults, using only state funds.

The federal government does contribute to Emergency medicaid,which reimburses hospitals for emergency medical care provided to individuals who do not typically qualify for Medicaid due to immigration status or other factors. This program was established in 1986 under the Emergency Medical Treatment and Labor Act, signed into law by President Ronald Reagan.

In 2023, Emergency Medicaid accounted for a mere 0.4% of total Medicaid spending.

Despite this, some conservative lawmakers argue against providing any Medicaid benefits to immigrants without legal status. Rep. Dan Crenshaw, R-Texas, stated on social media that “Medicaid is meant for American citizens who need it most — seniors, children, pregnant women, and the disabled. But liberal states are finding ways to game the system and make taxpayers cover healthcare for illegal immigrants.”

Myth 4: Do Latinos Stay on Medicaid for Decades?

Experts indicate that there is no specific analysis available that breaks down the length of Medicaid usage by race or ethnicity.

The people who stay on Medicaid the longest are people who have Medicaid due to a disability and who live with a medical situation that does not change.
Jennifer Tolbert, deputy director of KFF’s program on Medicaid and the uninsured.

Individuals requiring long-term Medicaid support services represent only 6% of the total Medicaid population. Many beneficiaries are enrolled in the program temporarily.Timothy mcbride noted that “Some studies indicate that as many as half of the people on Medicaid churn off of Medicaid within a short period of time,” often within a year.

Myth 5: Are Latinos on Medicaid the Group That Uses Medical Services the Most?

Data suggests that Latinos do not utilize Medicaid services considerably more than other groups. Actually, Latinos frequently enough receive preventive services, primary care, and mental health care at lower rates compared to other populations, according to data from CMS and the Medicaid and CHIP Payment and access Commission.

Though, Latinos do represent a disproportionate share of Medicaid labor and delivery services. Latino and White families each account for approximately 35% of Medicaid births, despite White individuals comprising a larger portion of the overall population.

While Latinos represent 28% of all Medicaid and CHIP enrollees, they constitute 37% of beneficiaries with limited benefits covering only specific services.

They actually use health care services less than other groups, as of systemic barriers such as limited english proficiency and difficulty navigating the system.
Arturo Vargas Bustamante, a professor at UCLA’s Fielding School of Public health and faculty research director at the university’s Latino Policy and Politics Institute.

Vargas Bustamante also noted that Latino individuals sometimes avoid using services due to fears related to the “public charge” rule

Medicaid Myths & Realities: Unpacking Latino Enrollment and Usage

Is it true that Latinos are the largest group using Medicaid, and that most don’t work? The data tells a far more nuanced story.

Interviewer: Dr. Elena Ramirez, a leading expert in healthcare policy and disparities, welcome to World Today News. Your extensive research focusing on Medicaid enrollment and usage among Latino communities makes you uniquely qualified to address the pervasive myths surrounding this critical topic. Let’s start with the biggest misconception: the notion that Latinos on Medicaid are predominantly unemployed.

Dr. Ramirez: That’s a harmful and inaccurate generalization. The reality is much more complex. While it’s true that many individuals enrolled in Medicaid are low-income, a important portion of Latino Medicaid recipients are, in fact, employed. Studies consistently show a significant percentage of Latinos enrolled in Medicaid are actively working, frequently enough in jobs that don’t offer affordable health insurance benefits. This highlights a critical issue: the lack of accessible and affordable healthcare options for working families, irrespective of ethnicity. The myth that they don’t work perpetuates harmful stereotypes and obscures the underlying systemic challenges contributing to their Medicaid enrollment.

Interviewer: Let’s address another common misconception: the belief that Latinos constitute the largest group enrolled in Medicaid.

Dr. Ramirez: This is another falsehood. While Latinos make up a significant portion of Medicaid recipients, typically representing a large percentage of their own population, data consistently shows that non-Hispanic whites have the highest raw numbers of enrollment. The focus should shift from raw numbers to examining the proportion of Medicaid enrollment within specific ethnic groups. What we find is that, considering the total population, Medicaid enrollment is proportionally higher within the Latino community than it is for othre ethnic groups. This disproportionate enrollment doesn’t necessarily point to overuse, but rather reflects existing health disparities and barriers to access to affordable healthcare. It’s critically important to understand that while the raw numbers show a different picture, a proportional analysis points directly to the systematic issue needing action.

Interviewer: A significant aspect of the debate surrounds immigrant access to Medicaid. are undocumented immigrants a major driver of Medicaid costs, as some claim?

Dr. Ramirez: The assertion that undocumented immigrants heavily burden the Medicaid system is misleading. Federal law places significant restrictions on Medicaid eligibility for individuals without legal status. while some states provide limited coverage using state funds, the overall impact on the national Medicaid budget remains relatively small. Emergency Medicaid, wich covers emergency care for individuals regardless of immigration status, represents only a tiny fraction of total Medicaid spending. Focusing solely on undocumented immigrants distracts from addressing broader systemic issues impacting healthcare access for all low-income individuals. This is an important matter because it obscures the more significant problem of a system that doesn’t adequately serve the needy individuals who lawfully live in the country.

Interviewer: How about the length of Medicaid enrollment? Are Latinos consistently enrolled for decades?

Dr. Ramirez: There’s simply no evidence to support the claim that Latinos—or any particular ethnic group—stay on Medicaid for unusually long periods. Medicaid enrollment is often temporary, tied to specific life events like job loss, illness, or pregnancy. The duration of enrollment is influenced more directly by individual circumstances and the type of healthcare needs involved. For some, particularly those with chronic conditions that require ongoing care, coverage might potentially be necessary for extended periods. We must be careful in not generalizing any specific demographics, particularly based on their race or background.

Interviewer: let’s dispel the myth that Latinos overuse Medicaid services.

Dr. ramirez: There’s no support for the claim of substantial overuse. in many cases, data suggests that Latinos may utilize preventative services, primary care, and mental health services at a lower rate than other groups. This disparity suggests critical barriers that prevent them from accessing necessary care, rather than overconsumption. These barriers range from language difficulties and a lack of culturally competent providers to fear of the “public charge” rule. Addressing these underlying issues is crucial to ensuring equitable access to healthcare for all. Many members of this demography do not utilize the benefits because they don’t even know that it’s accessible to them.

Interviewer: Dr. Ramirez, thank you for shedding light on these critical misconceptions.your insights offer a valuable corrective to the misinformation often circulating about Medicaid and the Latino community. What are some of your key recommendations for improving the healthcare system to better address the needs of this community?

Dr. Ramirez: We need to focus on increasing access to resources—improving affordable health insurance availability, addressing language barriers through translation services, implementing cultural sensitivity training for healthcare professionals, and creating clearer pathways to enrollment and benefits access for everyone.

Key takeaway: The conversation surrounding Medicaid and Latino enrollment needs to shift away from harmful stereotypes and toward addressing systemic inequalities in healthcare access and affordability.

Call to action: Share your thoughts on these critical healthcare issues in the comments below! Let’s work together to advocate for equitable access to healthcare for all.