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Thorny Issues Emerge as GOP Seeks Latino Support to Repeal Obamacare

Image: FILE PHOTO - Applications are seen at a rally held by supporters of the Affordable Care Act in Jackson Mississippi

File photo of the federal government forms for applying for health coverage outside the Jackson-Hinds Comprehensive Health Center in Jackson, Mississippi, U.S. on October 4, 2013. Jonathan Bachman / Reuters

WASHINGTON - As Republicans try to persuade Latinos to join them in dismantling Obamacare, they may have to confront the reasons why even though millions more Hispanics have gained coverage, a greater share than other Americans remain uninsured.

Those factors include the number of lower income Latinos living in states like Texas and Florida that chose not to expand Medicaid under Republican legislatures and the number of Hispanics who lack legal status or are legal residents and don't qualify for Obamacare or Medicaid under their state.

How support from Hispanics — and Republicans who represent some of them in swing congressional districts — is playing into the GOP's attempt to repeal Obamacare was demonstrated this week when American Action Network launched a Spanish-language television and digital ad in six GOP House districts. The districts have significant Latino populations.

Tom Price, Trump pick for Health secretary, faces questions on Obamacare repeal 2:27

The American Action Network, a conservative political group affiliated with a Super PAC of House Speaker Paul Ryan, paid for the ad. Cory Bliss, American Action Network's executive director, said the ad, running on Telemundo and Univision, is part of an effort to inform all Americans "there is a conservative, patient-centered solution to Obamacare." Ads with a nearly similar message have already been released in English for the $1.4 million advertising campaign.

American Action Network spokesperson Ruth Guerra said the ad campaign highlights that House Republicans have a plan "that will provide families an option with quality care and affordable care."

About 4 million Hispanics have obtained health insurance through Obamacare. In a news release, Bliss asserted that "the number of uninsured Hispanics has grown."

In fact, the number of Hispanics without health care has dropped, meaning the percentage of Hispanics without insurance has gone down.

Before Obamacare, 10.7 million of the 37 million people without coverage were Latinos. Now, there are about 27 million Americans without coverage and about 9.6 million are Latino.

"The evidence is so clear the law has expanded coverage for so many people," said Sara Collins, vice president for health care coverage and access at The Commonwealth Fund.

Related: Obamacare Repeal Would Leave 18 Million Uninsured; Send Premiums Soaring: Report

American Action Network's press release points to a an NBC Latino story that cites a Commonwealth Fund report that found that the share, though not the number, of uninsured Hispanics grew. Latinos are 40 percent of all uninsured, including whites and blacks, a share that grew from 29 percent in part because Hispanics gained coverage at a slower rate than whites.

As the number of uninsured adults has fallen, Latinos have become a growing share. The Commonwealth Fund

The report cites several reasons why Latinos are a growing share of the uninsured, among them:

- Many uninsured Latinos live in states such as Texas and Florida that opted to not expand Medicaid under Obamacare.

-- There is a disproportionate share of Latinos who are poorer or lower income but not eligible for Medicaid either because their state didn't expand the program or they are not aware of eligibility.

-- There are Latinos who are legal residents and their state restricts access of legal immigrants who have not had legal residency for at least five years, as the Affordable Care Act allows. Some may not know, however, that 29 states and D.C. have waived the restriction and the ACA allows legal residents in states that didn't expand Medicaid to apply for coverage and subsidies through the marketplace, regardless of income. (The uninsured rate among U.S. born Latinos is about 12 percent but for foreign born Latinos, it is 39 percent.)

-- Many Latinos are immigrants who don't have legal status and therefore are not eligible for Obamacare. Immigrants who benefit from the Deferred Action for Childhood Arrivals, DACA, program also are not eligible for Obamacare. (Attempts to extend Obamacare to immigrants without legal status drew heavy Republican opposition while the law was being debated.)

-- There are Latinos who qualify for coverage under Obamacare but won't sign up out of fear that their family members who lack legal status may be found out by the government and detained and deported. The fear of turning over information to the government has increased with the election of Donald Trump.

Related: As GOP Rushes Appeal Obamacare Has Never Been More Popular: NBC/WSJ Poll

These are factors that would have to be addressed in order to make a dent in the number of Hispanics who are uninsured.

Democrat Rep. Raul Ruiz, who is a physician, criticized the Republican campaign, calling it a "big lie — they only have old failed ideas that would actually reduce health insurance coverage, increase costs and increase profits for insurance companies," he said.

Support for Obamacare in the Hispanic community has grown; 57 percent of Hispanics polled in 2016 approved, up from 47 percent in 2014. An October Latino Decisions poll found most Hispanics agree that the federal government should require people to have health insurance; nearly 80 percent of Florida Hispanics agreed with Medicaid expansion to insure more lower income people.

Hispanics tend to focus on health care more than a non-Latino audience, said Mike Madrid, a a political strategist at GrassrootsLab in California.

The ad is being broadcast in heavily-Latino districts of certain Republican legislators: Rep. Jeff Dunham, California Congressional District-10; David Valadao, California CD-21; Mike Coffman, Colorado Congressional District 6 and Barbara Comstock, Virginia CD-10. A digital version of the ad will be distributed in the district of Rep. Carlos Curbelo, Florida CD-26.

The ads "are trying to soften up the Latino electorate, saying we can do better, we should do better so these congressional members vote to do better," said Madrid. He said he'd expect to see ads expand to English speaking Latinos.

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