Latinos at the Center of the Solution: Fighting for a Health Care System That Works for Everyone

As Hispanic Heritage Month kicked off on September 15, federal policy was already threatening the health and financial security of Latino families. Three days in, a new public charge rule took effect, spreading fear among Latino families who might be impacted about whether to disenroll from coverage. In California alone, it is estimated that up to one million Latino Medi-Cal enrollees could disenroll, including as many as 380,000 U.S. citizen children. Two weeks later, on October 1, H.R. 1 cut off Medicaid and CHIP for thousands of refugees, asylees, and other immigrants who came here through lawful humanitarian pathways. Despite political rhetoric to the contrary, the vast majority of Latino immigrants are in the country lawfully, and these policies, among others by the Trump Administration, make clear that lawful status no longer protects families' health and well-being.

For the more than 68 million Latinos who call America home, nearly eight in ten of whom are U.S. citizens, this is a moment of contrast. Latino workers and taxpayers help uphold our health care system. Yet, Latino families are among the hardest hit by the nation's affordability crisis, by congressional Republican's historic health care cuts, and by extreme approaches to immigration enforcement.

Latinos across the U.S. are taking a stand, fighting to protect coverage, challenging harmful policies, and building a health care system that works for everyone, no matter who they are or where they're from. Their voices must be central to undoing the harm and building a more just health care system.

What's at Stake

The October 1 cutoff is only the beginning. H.R. 1's immigrant restrictions could leave about 1.3 million lawfully present immigrants uninsured by 2034, including many Latino families with Temporary Protected Status (TPS) who will lose Marketplace subsidies next year. According to UnidosUS, more than four million Latinos are among the roughly 14 million people projected to lose coverage because of H.R. 1 and the expiration of enhanced premium tax credits. About two-thirds of Latino adults on Medicaid already work, yet 52% of Latinos who lost Medicaid during the pandemic unwinding remained eligible for coverage but not enrolled. Even more working Latino families could lose Medicaid next year, not because they don't qualify, but because a flawed administrative system fails to keep them enrolled.

Keeping coverage does not guarantee affordable care. Just 32% of Hispanic adults can consistently afford the care and prescriptions they need, compared with 55% of White adults. Latinos account for an estimated 27% of ACA Marketplace enrollees, leaving many vulnerable to higher premiums now that enhanced premium tax credits have expired. And 19.1% of Latino adults carry past-due medical debt, compared with 12.8% of White adults.

When Fear Becomes a Barrier to Care

For immigrant families, fear compounds the harm. And the impacts are clear: In Edinburg, Texas, a mother of four U.S. citizen children refused to go to the hospital after a bad fall because she feared being separated from her family. The new public charge rule gives immigration officers broad discretion to weigh the use of programs like Medicaid and SNAP in green card decisions, and even before it took effect, the share of immigrant parents whose families stopped using such programs over immigration concerns had risen from 11% to 18%. When people are afraid to seek care, they don't stop getting sick. They come in later, and sicker. And that leads to higher costs and worse outcomes for them, their families, and their communities.

Holding Up the Health Care System

There's another contradiction in these policies. Latino workers make up nearly a third of the home health aides and medical assistants who deliver essential care to older adults, people with disabilities, and families across the country. Latino labor also fuels a $4.4 trillion economy that helps finance coverage for all Americans. Cutting coverage for the people who care for others weakens the system for everyone.

Leading the Work to Undo the Harm

Latino-led and immigrant serving organizations have shown us what a more equitable health care system could look like. UnidosUS is calling for seamless, paperless coverage and stronger health programs, while its nearly 300 Affiliates help mixed-status families enroll and stay covered. Hispanic Federation is mobilizing Latino communities against the cuts, and the Organization for Latino Health Advocacy (OLHA) uses community-based research and advocacy to push for affordable, culturally competent care. In California, the California Pan-Ethnic Health Network and the California Immigrant Policy Center organized immigrant communities to win a delay in planned Medi-Cal cuts for refugees, asylees, and other humanitarian immigrants. In Colorado, the Colorado Consumer Health Initiative has defended coverage for immigrant children and pregnant individuals, a priority Latino-led groups like COLOR have also championed. What works for Latinos works for all of us.

Taking Action in the States

Advocates can build meaningful partnerships with Latino and immigrant-serving organizations so those most affected shape the solutions. They can also call on state policymakers and agency officials to:

1. Adopt the federal option to cover lawfully present children and pregnant people.
2. Fund state premium subsidies to replace the expired enhanced premium tax credits, as New Mexico did.
3. Invest in language access across websites, call centers, and eligibility offices.
4. Rein in hospital prices, strengthen insurer rate review, and protect patients from medical debt.
5. Use automated, paperless verification for work requirements so eligible people aren't lost to red tape.
6. Collect and report data disaggregated by race and ethnicity to reveal disparities.
7. Support storytelling efforts that document the harm of the Trump Administration's policies.

The best way to honor Hispanic Heritage Month is to protect the health of Latino families and fight for a health care system that serves us all. The question isn't whether Latinos will shape the future of American health care. It's whether policymakers will listen. The health of Latino and immigrant communities is the health of our nation.