New Book Studies Why Many Latinos Lack Health Insurance | Latin Voice | Chicago News

When President Barack Obama signed into law the Affordable Care Act 12 years ago, it was intended to lower the cost of health insurance for those who qualify and increase the number of Americans with access to health care. But despite the rollout of the ACA, which included expanding Medicaid eligibility among other things, the rate of uninsured among Latinos remains more than double that of non-Latino whites.

Through in-depth personal interviews conducted over three years, the University of Chicago sociology professor Robert Vargasthe new book”Uninsured in Chicago: How the Social Safety Net Leaves Latinos Behinddives deep into what keeps Latinos from feeling excluded from accessing health care. Vargas followed 40 Chicago residents, mostly Latinos, as they learned about the options available to them under the provisions of the ACA.

“What I learned was that the legacies of people’s experiences with the health care safety net and government more broadly from the past – those legacies mattered enormously to how people viewed the law on affordable care, how they made sense of the information coming from the government, and then ultimately how they decided whether or not to enroll,” Vargas said. “For many low-income, uninsured people in Chicago, the first place to go if you’re really in dire straits for health care is the county emergency room. And I don’t know how many people often go to county ERs, but the experience is often very hectic. He has very long expectations. And then, at the end, people leave with a very large medical bill. And so it was often a common perception that people when they heard about ACA, they thought that was what it gave them access to.

The book looks at how the unaffordability of prescription drugs – including drugs like asthma inhalers – can lead to criminal records for the uninsured. One of those interviewed by Vargas, whom he calls Nick, felt like he was in a “lose-lose situation” due to his insecurity and severe asthma.

“His options were to go to the county ER and wait through these asthma attacks…and he was telling me he was avoiding going to the county ER for fear of dying in the waiting room,” said said Vargas. . “He had another option of going to the private university ER where he could get access to a doctor much faster but then end up with a huge medical bill at the end and run up debt. He had another option to try to save money, but saving money for asthma inhalers that cost hundreds of dollars, takes time for people who don’t work in high-paying industries. of the labor market.

“A method of last resort was to resort to shoplifting and the sale of second-hand items and to use the proceeds generated from criminal activity to pay for asthma inhalers in the informal economy” , Vargas continued. “He took the latter option and then eventually got caught and was jailed.”

Vargas said one aspect of the Affordable Care Act that he says has yielded positive results is the program’s “health navigators.”

“They are not quite social workers. They are not quite community health workers. Their job is basically to be credible messengers to help connect people to the healthcare system,” Vargas said. “It created an interpersonal connection so that the deeply disconnected and deeply disadvantaged felt like they had at least one advocate and someone by their side to navigate all the potential landmines that come with interfacing with a net. social security in tatters.”


Nick’s asthma made him look like a broken ventilator. It hit as we were driving south on Pulaski Road, crossing the Chicago Sanitary and Marine Canal toward a movie theater. With the downtown skyline visible in the distance, I asked Nick, in the passenger seat, “When you breathe like that, how do you feel?”

Catching his breath, Nick gasped, “Like I’m breathing through a straw.”

Nick took a green inhaler from his pocket, gave it a good shake and took a puff. His crackling breathing stopped only slightly. The inhalers he had bought out of pocket from a neighborhood drug dealer for $20 were losing their effectiveness. We scrapped our movie plans because Nick feared the heavily air-conditioned theater would make his asthma worse, and instead ate lunch at the buffet in Chinatown. Nick walked cautiously from the parking lot to the restaurant.

Uninsured and 28-year-old Nick had contracted asthma in his early twenties. When his first asthma

Nick couldn’t really turn to his family for help. The youngest of three children, Nick was largely raised by his older sister after their young Mexican American parents divorced. Their mother left the family and remarried. Their father died of cancer in 2011. And Nick’s brother, a member of the Latin King gang, was serving a 20-year prison sentence. Now only his older sister, Stacy, and his girlfriend, Karen, were a part of his life.

Living with asthma and without inhalers made it difficult for Nick to hold down a job. He finished high school but never went to college, and he had a tendency to jump from job to job – he had worked for Amtrak, at an air conditioning repair company and as an usher at the United Center where the Chicago Bulls and Blackhawks play. Developing asthma and suffering from his oxygen deprivation slowed his body and mind, making Nick late for work or unable to complete basic tasks. He would get fired after too many mistakes, then go find another job that was sure to be temporary.

Employed or unemployed, Nick was uninsured and needed inhalers. The prospect of dying of an asthma attack haunted him. A friend referred him to a neighborhood drug dealer, and when he had the money, Nick bought the inhalers that way. When he had no cash, his asthma attacks sent him, reluctantly, to the nearest hospital emergency room where he could receive treatment but go into further debt.

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