As we enter the third year of the pandemic, nearly half of Americans feel that we need to “learn to live” with COVID-19 and get back to normal. The Build Back Better Act (BBB) — which put forward a vision of an inclusive recovery from the pandemic — has stalled in Congress.
Amid efforts to reset his agenda, President Biden used his State of the Union address to lay out parts of his plan for moving the country forward. Congress must now tackle the urgent health and food security needs of the country by passing elements of BBB into law.
Any discussion about a “return to normal” must recognize that “normal” is what led to the disproportionate suffering Latinos and other communities of color experienced. Latinos are nearly twice as likely to die from COVID-19 compared to non-Hispanic whites. As Congress debates what to do next, more than 152,000 Latinos have died from the pandemic and Latinos make up nearly 1 in 4 cases.
“Normal” was a world where Latinos had the second-highest rate for those without health insurance, the rate of uninsured Latino children was moving in the wrong direction and immigrant restrictions on programs like Medicaid and the Affordable Care Act Marketplace disproportionately impacted Latinos’ access to health coverage.
To make matters worse, the Trump administration stigmatized access to benefits through restrictive changes such as the public charge rule — which penalized immigrants using certain types of public aid when they applied for lawful permanent residence — and drastically cut outreach to help enroll those who are eligible for coverage, including forms of outreach that Latinos rely on more than other groups. Equally important, “normal” was a world where more than 2 million Americans, including more than 610,000 Latinos, lived in the Medicaid coverage gap, with no viable pathway to affordable health coverage.
Prior to COVID-19, more than 15 percent of Latino households were food insecure — nearly twice the rate of white households. This disparity only grew worse during the pandemic. One reason may be that adults in immigrant or mixed-status families are continuing to avoid public benefit programs like the Supplemental Nutrition Assistance Program due to the public charge rule’s chilling effects (even though the rule has since been changed).
Federal relief eased the burden for many. The American Rescue Plan Act made key improvements to health coverage and food security which have benefited Latinos. The act made it possible for millions of Americans to receive increased financial assistance to lower their premiums. Previous relief also included the Pandemic EBT (P-EBT) program, which has been a lifeline for students throughout the pandemic.
This was consequential, and the president can and should take a victory lap, considering the gains in health equity under his watch. More than 3 million uninsured Latino adults qualify for low-premium coverage as a result of the act, including 2.6 million who now qualify for plans with fully subsidized premiums. When the American Rescue Plan’s enhanced subsidies became available during part of the special enrollment period that President Biden opened in January, more than 560,000 Latinos enrolled in coverage (with Latinos making up a larger share of new enrollments than the year before). Yet these improvements will expire after this year. And while P-EBT is a temporary program, children’s need for healthy food during school breaks (e.g., the summer months) is not. At the same time, a health coverage cliff is approaching, which could jeopardize coverage for millions of Latinos unless Congress acts. The BBB contains key policies to help the country recover from the pandemic and improve children’s access to food.
A return to normal without adequate investments in health coverage and food security also ignores the fact that COVID-19 has left us with new challenges. Due to the systemic failures on the front end, Latinos are more likely to contract COVID-19, leaving them at greater risk of developing “long COVID.” The pandemic also worsened Latinos’ mental health. Inasmuch as a return to normal means the end of the Medicaid disenrollment freeze, this shift would risk dramatically increasing the number of uninsured Latinos and further driving up medical debt for families already impacted by higher food and gas prices. Investments in affordable health care can help Latinos struggling to meet many needs as our economy recovers.
Congress also has a rare opportunity to deliver concrete and long-overdue relief for the Americans who fall into the Medicaid coverage gap. While not a long-term solution, Build Back Better’s marketplace-based proposal to close the coverage gap would have better positioned more Americans to recover from the health and economic crises of the last two years.
For the Latino community, a so-called return to normal means returning to a world where more people were hungry, uninsured and less healthy. We cannot recover from a pandemic while being cautious about health coverage expansions or failing to tackle the hunger disparities exacerbated by the past two years. Whatever the political complexities, we cannot simply go back to the world that preceded COVID-19. Not only is it unrealistic, it’s undesirable.
Matthew Snider is a senior health policy analyst at UnidosUS, formerly the National Council of La Raza, a Latino civil rights and advocacy organization.