National Hispanic Leadership Comments on Climate, Health, Environment

We are facing an existential climate emergency that, if not sufficiently and urgently addressed, could seal the devastating fate of our planet and our families. Latinos recognize this challenge and are more willing to get involved politically with environmental issues than any other group.90 The majority of U.S. Latinos live in areas that have experienced devastating impacts of extreme weather events, such as Hurricanes Irma and Maria in Puerto Rico, longer and stronger wildfires in California, flooding from sea level rise in Florida, and historic drought and heatwaves in Texas, all
of which have had deadly impacts on these communities. Changes in climate and extreme weather are hitting our communities hard
and magnifying the existing vulnerabilities that many Latinos already face, such as environmental degradation and the poisoning
of our land, air, water, and food, leading to
disproportionate exposure to toxins, pollutants,
and environmental hazards at home and in
the workplace. Addressing the climate crisis
and other environmental issues will require
a transformation and significant investment
in the U.S. workforce and economies at the
national, state, and local levels.
Race and poverty are some of the strongest
predictors of environmental degradation in
communities such as lack of access to clean
water and sanitation91 and violations of air
quality standards.92 Close to 2 million Latinos
live within a half-mile of an oil and gas facility,
close enough to have concerns about the
health impacts of pollution.93 Asthma has a
disproportionate impact on Latino families
living in communities with poor air quality. For
example, Latino children are twice as likely to
die of asthma than non-Latino Whites. Poor air
quality results in 750,000 summertime asthma
attacks in children and 500,000 missed school
days. Among Latinx adults, this pollution
results in 2,000 asthma-related emergency
room visits, 600 hospital admissions, and 1.5
million reduced activity days.94

Environment and Gender

The World Health Organization found that
natural disasters such as droughts, floods,
and storms kill more women than men, and
tend to kill women at a younger age. The
gender-gap effects on life expectancy tend
to be greater in more severe disasters, and
in places where the socioeconomic status of
women is particularly low.95 We know that in
the U.S., Latinas are vulnerable because they
face social, economic, and political barriers
that further limit their coping capacity. As
NHLA member organizations’ research has
shown, Latinas are the most vulnerable of all
groups at the workplace, and the situation
is even worse for undocumented Latinas.
Thus, in the policymaking response to
environmental challenges, it is important to
include gender-sensitive strategies.

Climate Crisis Emergency

In 2018, the United Nations Intergovernmental
Panel on Climate Change (IPCC) 1.5°C
Special Report concluded that if the global
temperature rises by 1.5°C, humans will face
unprecedented climate-related risks and
weather events. It warns that action must
be taken to lower global net human-caused
emissions of carbon dioxide (CO2) by about 45
percent from 2010 levels by 2030, reaching netzero
carbon emissions by 2050.96
Climate change is increasing the frequency
and intensity of extreme weather events,
including hurricanes, wildfires, droughts,
floods, and extreme heat days. Communities of
color are on the frontlines of the environmental
and public health impacts of climate change.
We must ensure that climate solutions address
these inequities and provide justice for these
Climate-related migration across the world is
increasing as a result of food insecurity caused
by environmental changes and climateinduced
disruptions, including weatherrelated
disasters, drought, famine, and rising
sea levels. According to the UN International
Organization for Migration, by 2050, there may
be as many as 200 million climate-displaced
persons.97 Climate-forced migrants and other
environmental migrants98 face additional
risks during their journey and after they
arrive at their destination. Many migrants are
exposed to trauma, violence, and unhealthy
conditions in their country of origin, along their
migration journey, and in their new country of
residence. Environmental migrants often lack
formal protections under U.S. or international
law. While the effects of climate change
can aggravate societal tensions that lead to
persecution, many climate-displaced persons
do not yet meet the definition of a refugee
under international or domestic law.

• Implement comprehensive climate policies
and legislation to reduce Carbon Emission
to meet recommendations of the United
Nations Intergovernmental Panel on
Climate Change (IPCC) 1.5°C Special Report
to combat the climate crisis to ensure a
safe, healthy, and prosperous future.
• Ensure comprehensive climate policies and
legislation maximizes co-benefits, such as
green jobs and reduced air pollution.
• Recommit United States participation
and leadership in international efforts to
address climate change such as the COP
21 Paris Climate Agreement and ratify such
participation by Congress.
• Engage Latinos meaningfully through
multiple public hearings in impacted

• Immediately establish a safe and hygienic
process for climate-related migrants to enter
the country and process their immigration
status, in consideration of the COVID-19
• Support the U.S. as an active leader in
international discussions to support and
find solutions for the Global Climate Change
Resilience Strategy that would include global
protections for climate-forced and other
environmental pressured migration.
• Direct the U.S. State Department and the
U.S. Agency for International Development to
create and implement a new humanitarian
program for international migrants who have
been displaced by environmental disasters or
climate change.
• Collect and maintain data on displacement
caused by climate change and release an
annual report with an analysis of the data.
• Support robust funding of the U.S.
contribution to the Green Climate Fund
(GCF), a fund designed to address the critical
needs of developing nations, including Latin
America, to foster resilience to the effects of
climate change and to support low-carbon


To ensure the health and well-being of Latino communities across the nation we must understand the
current environmental inequities experienced by these communities, the impacts on their health, and
promote policies that elevate and center environmental justice (EJ) for communities.

communities and public comment periods
of an average of 60 days that are accessible in
multiple languages, on the implementation
of environmental laws including those
meant to address disproportionate impacts
on communities of color and low-income
• Expand research identifying preventative
measures that address impacts (e.g. health,
economic, safety, etc) that climate change
will have on vulnerable populations, including
elderly, children, members of the LGBTQIA+
community, women, people experiencing
homelessness, and workers.
• Expand research on transitioning
and building ethical and transparent
governments that are climate prepared,
climate-resilient, and advance equity and
justice for vulnerable communities.
• Support and develop policies and programs
that provide financial investments to
create climate-resilient communities (e.g.
infrastructure replacement and hardening,
water resource management plans, clean
energy technology, and workforce training).
• Appropriate disaster relief and other federal
funds and release them in a timely and legal
manner without additional restrictions and
barriers to access, which are not required of
other post-disaster entities.
• Align all federal, local, and private investments
and plans to support the achievement of the
government’s 100 percent renewable portfolio
standard by 2050.
• Enable all affected persons to access
emergency services, food, and shelter
following natural disasters, regardless of
immigration status.
• Ensure mitigation dollars and planning are
undertaken with the full input of affected
communities; displacement and disruption
of historic communities should be the last
• Bolster Puerto Rico’s agriculture sector and
promote resilient and sustainable local food
production, and access to safe, potable water.
• Prohibit waivers of any civil, human, or
environmental rights in the name of speed or
greed. Rebuilding and recovery in Puerto Rico
should not be an excuse for exploitation or
• Prioritize mitigation before displacement
in the recovery and rebuilding process. All
communities should receive equitable and
just access to resources and treatment,
regardless of income, property value, location,
or other qualifiers.

Halt waivers of environmental pollution laws
that have been allowed since the onset of the
COVID-19 pandemic in the U.S.
• Require federal agencies to assess the
impact of a proposed action on human
health, environmental hazards, and access to
outdoor spaces and recreational activities and
produce a “community impacts report” on its
findings for any action that could harm an EJ
• Strengthen and support the enforcement
of existing public health and environmental
laws, including: the Clean Air Act; Clean
Water Act; Comprehensive Environmental
Response, Compensation, and Liability Act
(Superfund); Federal Insecticide, Fungicide,
and Rodenticide Act (FIFRA); Coal Ash
Regulations; National Environmental Policy
Act (NEPA); Methane Pollution Reduction
Standards; Mercury and Air Toxic Standards
(MATS); and the Resources Conservation and
Recovery Act (RCRA).
• Support the update of the Toxic Substances
Control Act (TSCA), a dysfunctional, 40-yearold
chemical safety law that has failed to stop
toxic chemicals from regularly being used in
common household products.
• Enact the Environmental Justice for All
Act to codify the National Environmental
Justice Advisory Council and the directives
of Presidential Executive Order 12898 on
environmental justice and to strengthen and

enforce environmental and civil rights laws,
such as Title VI of the Civil Rights Act.
• Require federal agencies to consider the
cumulative impacts (or pollutant levels) in
permitting decisions under environmental
laws such as the Clean Air and Clean Water
• Require federal agencies to develop,
implement, and report activities in a manner
that does not have a discriminatory impact
on environmental justice communities.
• Establish an environmental justice
ombudsman role within the Environmental
Protection Agency (EPA) to receive, review,
and process complaints and allegations
relating to environmental justice programs or
actions of the EPA.
• Increase funding and strengthen authorizing
language for environmental justice grant
programs that support research, education
outreach, development, and implementation
of projects to address environmental and
public health issues in EJ communities.


To meet the carbon emissions reduction necessary to address the climate crisis, we must reduce our
nation’s and communities’ dependency on fossil fuels, non-renewable and finite resources, including
natural gas, that are the main drivers of climate change. We must ensure a just transition to a clean
energy economy and way of life for the sustainability of our planet and future generations.

Support legislation which would prohibit
electricity shutoffs, mandate reconnections,
and ensure electricity affordability
protections for low-income households
during the COVID-19 national emergency
and beyond.
• Promote the use of renewable power
generation and enabling technologies
(e.g. battery storage), energy efficiency in
buildings, and zero-emission engines across
all sectors.
• Support comprehensive federal legislation,
policies, and regulations that move the
U.S. towards utilizing 100 percent clean
energy, such as the Green New Deal and 100
percent Clean Economy Act by 2050.
• Support the establishment of a National
Renewable Electricity Standard that
requires retail electricity providers to
increase their supply of renewable
energy by a percentage of total retail
sales each year.
• Prioritize policies, programs, and regulations
that remove polluting energy facilities from
communities of color and increase access to
clean energy sources — such as solar, wind,
geothermal — for all Americans, particularly
frontline and low-income Black, Indigenous,
Latino, Asian, and multiracial communities.
• Promote policies and programs that
provide financial assistance for commercial
and residential building energy efficiency
retrofits, including the adoption of clean
energy technologies (e.g. solar panels and
battery storage) and retrofits that improve
indoor air quality, prioritizing frontline and
low-income Black, Indigenous, Latino, Asian
and multiracial communities.


In 2010, the United Nations General Assembly
recognized the human right to water and
sanitation and acknowledged that clean
drinking water and sanitation are essential
to the realization of all human rights.99 Yet,
many Latino communities across this country
are faced with devastating water quality
conditions including unsafe drinking water
contaminated with lead, coal ash and PFAS
and other toxics, inadequate wastewater
treatment infrastructure, unregulated and
contaminated, and unaffordable water service.
To ensure that all Latino communities have
access to clean water in their homes and
safe clean rivers, streams, and lakes, we must
strengthen laws and regulations protecting
water, improve enforcement of those laws,
and greatly increase federal investment in
sustainable water infrastructure.

Oppose efforts to weaken the Clean Water
Act through legislation and deregulation of
the Clean Water Rule of 2015.
• Support efforts to increase investment
in water infrastructure, drinking water
systems, wastewater systems, across the
nation, prioritizing investment in frontline
and low-income Black, Indigenous, Latino,
Asian, and multiracial households and
• Support efforts to create federal funding
streams for repair and maintenance of
aging decentralized wastewater systems,
prioritizing vulnerable communities like
Puerto Rico, Las Colonias,100 rural African
American communities, and the Navajo
• Support stronger implementation of
water equity goals across EPA programs
including programs focused on
infrastructure upgrades for drinking water
and wastewater utilities for low-income
communities, such as removing cost-match
requirements, adding grant payment
programs, and forgiving loans to small and
disadvantaged communities.
• Support the swift authorization and
passage of federal funds for drinking
water emergencies, such as communities
facing lead contamination and support
the use of federal grants by states for lead
contamination abatement projects. Also
support legislation increasing flexibility and
accessibility of water-emergency related
funding across federal agencies such as
• Support legislation that would prohibit water
shutoffs, mandate reconnections, and ensure
water affordability protections for low-income
households during the COVID-19 national
emergency and beyond.


Communities benefit from the ecosystem
services of well-balanced and protected natural
landscapes. Latinx communities understand
that it is critically important to protect our
wildlife, public lands, and endangered species.
We must work to ensure that Latinx people
see themselves represented in the histories
and places protected, as well as have access
to growing recreational and economic
opportunities. Multiple barriers prevent Latinx
communities from enjoying the benefits of
our public lands system. For example, Latinx
people disproportionately live in areas that offer
fewer park acres per person. Other barriers
include access to transportation, cost of entry,
cost of equipment, and unwelcoming social


Support efforts to improve wildlife
management and critical habitat across
federal and state agencies, including
defending and strengthening the
Endangered Species Act and improving
wildlife corridors.
• Protect public lands by:
◦ opposing and halting efforts to advance
oil and gas drilling in the Arctic
National Wildlife Refuge and other
sensitive areas; and
◦ supporting efforts to reach net-zero
emission of greenhouse gasses from
public lands and waters and support
the expansion of renewable energy
infrastructure on public lands when
• Ensure parks continue to exist for future
generations by:
◦ continuing to support full funding of
the Land and Water Conservation Fund
◦ supporting efforts to provide funding
to the Department of Interior to address
the various maintenance backlog
needs across the agency departments
including U.S. Fish & Wildlife Service,
National Park Service, and others;
◦ opposing all efforts to undermine or
repeal the Antiquities Act, which gives
the President the ability to establish
new national monuments or enlarge
existing monuments; and
◦ supporting efforts to re-establish and
expand the boundaries of Bears Ears
National Monument and Grand-Staircase
Escalante National Monument
to their original boundaries when first
• Oppose efforts to privatize public lands and
attempts to mandate development on our
public lands that could harm traditional and
growing uses by Latinos.
• Designate and protect public lands as

national monuments in urban areas to
increase access to public lands.
• Expand federal funding and programs to
increase public transportation options to
public lands for rural, urban and other underrepresented
communities, such as the Transit
to Trails Act of 2019.
• Create a national outdoor equity fund, similar
to that in the state of New Mexico, that
would make available grants to assist local
governments, organizations, and schools
to increase access to outdoor experiences,
environmental education, and more.
• Support efforts to identify, designate, and
protect more places that tell the historical
contributions, cultural connections to land,
and places of environmental significance
to Latinos within the national public lands
system as national monuments, historic sites,
national parks, and other designations. This
should include:
◦ establishing a Cesar Chavez
National Historic Park to protect
and commemorate the historic
contributions of Cesar Chavez and
other leaders of the United Farm
Workers Movement;
◦ designating the Chicano Park National
Historic Landmark as an affiliated site
of the National Park Service; and
◦ designating the Gila and San Francisco
Rivers and tributaries in New Mexico as
the Gila Wild and Scenic River.
• Expand research on the historic contributions
and places related to Latina & LGBTQ Latinx
individuals and how to ensure their inclusion
in existing parks or new designations.
• Protect the recreation economy by increasing
opportunities for Latino small businesses and
entrepreneurs to participate in the growing
recreation economy.


Our oceans and coasts are our greatest shared resources, serving as important critical food sources,
providing opportunities for social, economic, and cultural connections, as well as maintaining a rich
ecosystem with incredible biodiversity. Coastal communities across the nation and U.S. territories
depend heavily on marine-based economies, such as fisheries, tourism, and recreation.

Protect Ocean Ecosystems and Wildlife by:
◦ supporting federal agency policies
and funding ensuring that frontline
communities of color are prioritized for
coastal resilience projects;
◦ opposing efforts to undermine or roll
back existing marine monuments,
marine protected areas, and marine
◦ supporting efforts to protect 30 percent
of the ocean by 2030 by establishing
new marine monuments, protected
areas, and sanctuaries; and
◦ supporting federal programs that
promote coastal access, recreation, and
education for low-income and communities
of color.
• Protect sustainable fisheries by:
◦ supporting policies promoting sustainable
fisheries management and
involvement of coastal, low-income,
and minority community members
in fisheries training, construction, and
management; and
◦ supporting the modernization of the
Magnuson-Stevens Fishery Conservation
and Management Act to account
for existing and future climate change
impacts on fisheries and ocean health.
• Enact an offshore drill ban which should
include a permanent moratorium of
offshore drilling in the eastern Gulf of
Mexico and a banning of offshore drilling
along the Atlantic and Pacific coasts.
• Tackle the Plastic Pollution Crisis by:
◦ supporting legislation heavily curbing
plastic production, incentivizing
responsible recycling and disposal of
existing plastics products, creating
enforcement framework for holding
polluting companies accountable for
excess plastic production; and
◦ supporting legislation providing funding
to local organizations working
with frontline community members
who have been harmed by pollution
from nearby plastics refineries.


A just transition to a clean energy economy
depends on ensuring that the 1.5 million
people in the fossil fuel workforce have an
opportunity to access training and new jobs
in the burgeoning clean energy economy,
which already employs 3.26 million people
in the U.S.101 Three states with the highest
Latino populations are already leading on
clean energy job creation: California, Texas,
and Florida.

Support federal investment in worker
training programs to provide workers in
fossil fuel related industries with training to
enter new fields — whether in clean energy
or other areas where their skills may be
• Support federal investment in programs
at institutions of secondary education,
higher education, and trade to prepare
the incoming workforce with the skills and
education to be successful in transitional
and emerging job opportunities.
• Fund free childcare facilities at institutions
of secondary education, higher education,
and trade to enable Latino parents to more
easily access education and training.
• Invest heavily in HSIs, and promote
programs like Green Entrepreneurship,
Clean Energy Technology, and workforce
transition programs, particularly in
STEM careers where Latinos are largely
• Require employers to provide paid family
and parental leave regardless of gender,
equal pay by race and gender, and
healthcare benefits.
• Expand community-supported free highspeed
internet access in low-income
communities to support online learning
during the COVID-19 pandemic and after.


Latinos account for 83 percent of agricultural
field occupations that expose workers to health
hazards, bad air quality, and economic impacts
of extreme weather. The changing climate and
environmental conditions across the nation
are an ever-growing threat to the agricultural
industry causing severe damage to crops and
workers. Climate change is leading to longer
periods of droughts, more intense wildfires and
more extreme heat days, exposing farmworkers
to public health risks. Wildfire smoke remains
in the air for an extended time, carrying toxic
chemicals and causing dangerous air quality
conditions harmful to those without proper
respiratory protection. In efforts to quickly
get crops off fields during or after a wildfire,
farmworkers are often expected to put their
health at risk by continuing to work outside in
smoky conditions.
Additionally, heat-related illnesses, given rising
temperatures, are becoming increasingly
prevalent and dangerous amongst Latino
workers in jobs that require physical labor outside
during excessive heat, such as agricultural
work, construction work, and landscaping.
Many workers may not want to ask for or take a
break if they start to exhibit symptoms of heat
illness. Workers may also fear discrimination
or retaliation from their employer for speaking
up against unsafe work conditions. Without
protection from excessive heat exposure, workers
are susceptible to severe health issues and even
The Trump administration proposed to cut
farmworker pay at the onset of the COVID-19
pandemic to help the agriculture industry.
This is the opposite of what farmworkers –
and the country – need at this dire moment.
Farmworkers are essential employees during
the COVID-19 pandemic, and our food system
is relying on farmworker health and safety to be
prioritized during this time. More than half of all
farmworkers lack health insurance,102 and many
migrant farmworkers lack access to consistent
care from the same provider as a result of
frequent relocation. Protecting farmworker pay
and access to healthcare are critical to the safety
and stability of our country.

Enact the Farmworker Smoke Protection
Act of 2019, directing OSHA to develop
and publish an official standard to protect
employees affected by exposure to wildfire
• Enact the Asuncion Valdivia Heat Illness
and Fatality Prevention Act of 2019 (named
for a farmworker who tragically died from
heatstroke), which would require OSHA
to issue a federal standard for heat stress
protections with meaningful participation
of covered employees and tailored to the
specific hazards of the workplace.
• Protect farmworker pay, provide free
healthcare for all farmworkers, and increase
funding to rural health clinics.
• Develop COVID-19 prevention protocols and
guidance for farms and farmworkers.
• Provide the Department of Labor with
increased funding for occupational safety
enforcement in agriculture and end the
denial of funding for enforcement on
smaller farms.


Farmworkers, the majority of whom are
Latino, have one of the highest rates of
chemical exposures among U.S. workers. The
EPA estimates that up to 3,000 farmworkers
suffer acute pesticide poisoning every year
through occupational exposures.103 The
numbers are likely much higher. Several
factors contribute to the underestimation
of the problem, including the inability and
reluctance of injured workers to get medical
care, medical misdiagnosis, and the absence
of a coordinated national pesticide incident
reporting system. Agricultural workers and
their families suffer serious short- and longterm
health effects f rom pesticide exposure.
Yet, despite the urgent need to protect
farmworkers and their families from pesticide
exposure, they are afforded fewer protections
than workers exposed to chemicals in other
industrial sectors.

Ensure that the EPA fully implements and
adequately enforces the recently revised
Worker Protection Standard (WPS) to protect
agricultural communities and the public from
unreasonable harm from pesticides.
• Support stronger standards for workplace
safety for farmworkers, including the banning
of extremely toxic pesticides, such as
chlorpyrifos, and stronger precautions against
• Support a federal policy mandating the
reporting of pesticide use and illness
incidents to inform regulations that support
public health including pesticide use reform.


Environmental health is very important to
our communities because most Hispanics
live in areas that have air pollution from
carbon plants, automobile and truck exhaust,
lead, mercury and other chemicals in water
systems, pesticides, and household products.
Climate change, water and sanitation, and air
pollution negatively affect a variety of people
across the United States, primarily minority
groups. Black and Hispanic Americans
bear a disproportionate burden from air
pollution caused by non-Hispanic White
Americans; Hispanics experience 63 percent
more air pollution than non-Hispanic White
Americans.120 There is a clear racial gap
between who causes air pollution and who
suffers the consequences from it.
Asthma, a chronic disease, is a prevalent health
issue among the Hispanic community. With
Hispanics experiencing higher rates of air
pollution in comparison to non-Hispanic White

Americans, it is no surprise that Hispanics
are twice as likely as non-Hispanic White
Americans to visit the emergency room due to
asthma-related symptoms. Hispanic children
are also twice as likely to die from asthma
compared to non-Hispanic Whites.121 This
disparity must be addressed.

Address the inequities in pollution-related
health issues that primarily affect the
Latino population in the United States.
• Fund research to study the difference in
air pollution-related diseases amongst
racial groups.
• Educate members of Hispanic
communities affected by various
environmental health issues about
the general health effects related to
specific diseases caused by each of the
environmental health issues. Members
of the Hispanic population should be
informed in both English and Spanish.
• Require industries causing pollution to
disclose the environmental impacts to the
members of the community affected.


Hispanics represent nearly 60 million or 18
percent of the U.S. population and are the
largest ethnic group in the nation. Hispanics,
when compared to Whites, are poorer, younger,
have larger families, more Spanish speakers,
and mixed-families with undocumented
non-citizen members. Hispanics report their
households are food insecure at 18 percent
as compared to 9 percent of Whites, Hispanic
parents report their children live in an unsafe
neighborhood at 10 percent as compared to 3
percent of Whites, and Hispanics have a lessthan-
high-school education at 26 percent as
compared to 6 percent of Whites.
Due to low-incomes and living in communities
with food deserts, Hispanic families face
limited choices of healthy food and consume
excess sugar, carbohydrates, and less nutritious
fruits and vegetables. Thus, we have health
disparities and the trend of increasing obesity
and metabolic diseases, especially Type 2
diabetes with Hispanics having two times
the rate of diabetes compared to Whites.
Hispanic adults often face limited options for
employment and often work two jobs for basic
living expenses and go without healthcare and
behavioral healthcare. Toxic stress develops
without knowledge about healthy living,
leading to chronic diseases and symptoms
that are often ignored until later stages of the
disease, such as: hypertension, high cholesterol,
cardiovascular disease, cancers, non-fatty liver
disease, HIV, and depression.
Latinos are at a disproportionate risk of
being uninsured, lacking access to care,
and experiencing worse health outcomes
compared to Whites and those at higher
incomes. Even those who have private
health insurance face disparities, including
unaffordable healthcare services and less
access to regular providers and preventive
services in their neighborhoods. The costs of
medical care have all been worse for Latinos
as compared to Whites, including: regular
providers, use of preventive services, and costs
of medical care.104
The Affordable Care Act has increased health
coverage and the health status of Hispanics,
thanks to its elimination of pre-existing
conditions, expansion of child coverage on
parents’ plan to 26 years of age, free preventive
screenings, and many other provisions. From
2010 to 2015, Latinos under 65 who were
uninsured decreased from 22 percent to 13
percent. “Blacks remained 1.5 times more likely
to be uninsured than Whites from 2010 to 2018,
and the Hispanic uninsured rate remained over
2.5 times higher than the rate for Whites.”105
However, beginning in 2017, Congress and the
Trump Administration reduced the federal
government’s role in setting standards and
operations; for example, they reduced efforts to
encourage people to enroll, including zeroing
out the tax penalty for not having coverage.
Another example of the Trump administration
reducing the federal government’s role in

setting standards has been by allowing states
more flexibility to design the essential health
benefits package and alternatives to the ACA
under the 1332 waiver program.
Undocumented members of families
experience an extra burden when it comes to
decision-making about government assistance
programs that other family members are
eligible for such as WIC, SNAP, child and adult
nutrition programs, disability, and Medicaid for
maternal and infant care. Healthcare access
must expand for these and other immigrants.

Continue healthcare reform based on the
ACA, which must include:
◦ essential health benefits including free
preventive service and new mental
◦ education and outreach programs
during annual enrollment periods;
◦ exchanges at state/federal levels to
increase competition among health
◦ focus on primary care training of physicians;
◦ ensuring hospitals address racial and
ethnic health equity with community
assessments and programs to improve
the health of their target population.
• Develop policies that improve the
affordability of healthcare services, by:
◦ supporting the individual mandate for
health insurance;
◦ supporting health insurance tax credits
for individuals and small businesses;
◦ supporting subsidies for high-risk patients
for health plans;
◦ supporting cost-saving reductions for
health plans’ low-income clients;
◦ developing legislation that addresses
surprise medical bills;
◦ developing legislation that decreases
the cost growth rate of common
prescription drugs at the levels of the
manufacturers, PBMs, and point of sale
and supports generic drugs;
◦ increasing education for healthy lifestyles,
nutrition, physical activity, and
other key disease prevention programs
for the public;
◦ increasing discussions on terminal illness
and end of life care decisions; and
◦ decreasing admissions to hospitals and
increasing community and home care.
• Develop policies to increase healthcare
coverage for immigrants.
• Utilize fully the U.S. Citizenship and
Immigration Services’ (USCIS) Systematic
Alien Verification for Entitlements (SAVE)
system in, to address
instances where submission of additional
proof of status is required.
• Ensure that lawfully present immigrants
with incomes below the poverty line
are correctly determined eligible for
subsidies without requiring them to obtain
a Medicaid denial separate f rom their
Marketplace application.


Under Medicare, seniors receive preventive
services with no cost-sharing, annual wellness
visits with personalized prevention plans and
help with their prescription drug costs. States are
encouraged to expand their Medicaid programs
because it would increase access to affordable
health coverage for low-income Americans and
help individuals better manage their chronic
conditions. Congress should equip Medicare
for the economic and healthcare challenges
facing elderly Hispanics and all seniors by
enacting a catastrophic out-of-pocket limit;
counting all hospital observation days toward
meeting eligibility for skilled nursing facility
benefits; covering vision, dental and hearing
services; developing a paid caregiver workforce,
and addressing underlying costs, particularly
skyrocketing drug prices.
Medicaid is a critical source of healthcare
coverage for Latinos living in the United States.
Thirty-two percent of non-elderly Hispanics
(over 17.3 million individuals) in the United States
rely on Medicaid for coverage.106 Additionally,
nearly half of the 3.4 million Puerto Ricans living
in the U.S. territory have insurance coverage
through Medicaid.107 Additionally, many LGBTQ
Latinos rely on Medicaid for health coverage,
especially among transgender individuals. In a
2014 nationwide survey of LGBTQ people with
incomes less than 400 percent of the Federal
Poverty Guidelines, 61 percent of all respondents
had incomes in the Medicaid expansion range —
including 67 percent of Latino respondents.108
Medicaid expansion is instrumental in reducing
the uninsured rates of Latinos. Since many of the
states that have not expanded Medicaid have
high Hispanic populations, the lack of Medicaid
expansion is disproportionately impacting the
Latino community. In Texas and Florida alone,
more than one million otherwise eligible Latinos
are shut out from life-saving coverage.109

Support efforts by insurers and providers
to target the specific linguistic, cultural,
and social and environmental needs of
Hispanics to achieve greater equity in
access to and utilization of care and to
build on lessons learned from successful
strategies in Medicaid, given the program’s
long-standing experience serving a diverse
• Oppose proposals to cut Medicare benefits,
to repeal the Affordable Care Act, and
to reduce federal funding of Medicaid,
particularly since these actions would
disproportionately impact communities of
color, including Hispanic Americans.
• Support State policies to develop
healthcare for all programs, including
immigrants, that will serve as experiments
and lessons learned for a future nationwide
• Support Medicaid as an entitlement that
guarantees a certain level of benefits.
• Reject attempts to make Medicaid into
a block grant program, which would cap
funding and result in decreased access to
healthcare in vulnerable populations.110
• Support Health Equity and Access under
the Law (HEAL) for Immigrant Women
and Families Act which would restore
eligibility for Medicaid and CHIP to eligible
immigrants who are lawfully present and
are subject to the current five-year waiting
• Implement and protect Medicaid
expansion to those living at 138 percent
of the federal poverty line without
harmful and illegal provisions like work
• Maintain the integrity of the Medicaid
program by opposing any block grants or
per capita caps in Medicaid or altering the
financial structure of Medicaid.
• Implement a permanent and
comprehensive f ix for Medicaid for Puerto
Rico with increased funding that covers
eligible individuals at 138 percent of the
federal poverty level and coverage of all
health services guaranteed by Medicaid.
• Support the new social determinants of
health benefits for Medicare Advantage
beneficiaries including transportation
to healthcare related trips, meal delivery
for chronic disease patients, and housing
retrofitting for disabled or patients with
asthma (air conditioning, pest control).