For many Southeast Asian Americans, the Affordable Care Act (ACA) repeal fight last year felt personal.
When the ACA was first passed, uninsured rates in Cambodian, Hmong, Lao, and Vietnamese American communities were high. Compared to the 15% of Americans overall who did not have health insurance in 2011, 20% of Cambodian, 20% of Vietnamese, 19% of Laotian, and 16% of Hmong Americans were uninsured. Too many families used emergency rooms as last-resort healthcare providers or went for years without regular check-ups.
Only four years later in 2015, the uninsured rate was cut in half. Thousands of families were finally accessing the preventative and life-saving care that they needed. Some accessed care through the healthcare exchange, supported by subsidies to make the premiums affordable. Many others were finally able to access Medicaid after years of making too much income to qualify but not enough to afford other health insurance.
Older Southeast Asian Americans have particularly complex health needs that weren’t being met. The vast majority of Cambodian, Hmong, Lao, and Vietnamese Americans over the age of 60 came to the U.S. as refugees fleeing the U.S.-Vietnam war, indiscriminate bombings, torture, and persecution. Most speak only limited English – rates of limited English proficiency in Southeast Asian American older adults are as high as 89%. Many continue to bear the physical and psychological scars of war, suffering from high rates of depression and PTSD.
The ACA provided much-needed health and mental healthcare to older Southeast Asian Americans. Even for those who had healthcare coverage previously, the ACA created a mandate for all plans to cover certain essential services, including mental health. But the current administration has made the repeal of the ACA a priority, despite its widespread popularity and the tangible gains it has made in improving the health of our communities.
In response to these continued attacks on the ACA and Medicaid, SEARAC developed a coordinated campaign to fight back by collecting comments and testimonials from the Southeast Asian American communities who have benefitted so much from the law’s passage. SEARAC received over 350 comments from individuals across the country who described passionately how much the ACA and Medicaid expansion has meant to their families.
The campaign provided evidence that ACA is truly saving lives and improving the quality of life for Southeast Asian Americans across the country, including elders. Community members talked about accessing preventative care for the first time, or finally being able to diagnose and treat chronic conditions. Several mentioned the ACA’s mandate to cover certain essential services, like maternity care and mental health.
One 65-year-old Cambodian American wrote, “I am a survivor of Cambodian genocide. I have mental problems, diabetes, heart disease, high blood pressure, asthma, and stomach problems. My overall health is not great because of these health problems, but I am thankful to have health coverage. If not I wouldn’t be alive now.”
Another 89-year-old Vietnamese American respondent shared, “I tripped at home and broke my hip. Without Medi-Cal and Medicare, I would probably not seek the necessary medical services I need to care for my hip. I would have probably tried to save money by downplaying my injury or getting Asian herbs to try to heal it topically.”
Others made an impassioned plea for the importance of public health insurance for their families more broadly. One 63-year-old Hmong American wrote, “I am a disabled veteran with major PTSD. I cannot work and provide for my wife and six children. Please do not take away the state aid that helps our children prosper and grow healthily. Their children will also need the state’s aid if for any reason they are unable to provide for their children due to injury and loss of job and other circumstances.”
These powerful comments illustrate the broad reach that the ACA and Medicaid expansion have had into Southeast Asian American communities and add to the growing chorus of voices nationwide who are asking Congress to protect our care. The attacks on the ACA have shifted from outreach repeal to the systemic dismantling of its key provisions, from the sale of non-ACA compliant health plans to the burden of Medicaid work requirements. SEARAC will continue to work at the Federal, state, and local levels to push back against changes to the health law that will imperil the health of our communities. Our lives depend on it.
The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.