The standard social determinants of health model (race, income, education, access to care) does not have predictive power with Latino populations. In spite of having higher risk factors (eg, low income, education and access to care) than other populations, Latinos have better outcomes in a number of areas (chronic diseases, birth outcomes, smoking, etc.) in a phenomenon known as the Latino Epidemiological Paradox. Immigrant Latinos, who have even worse risk factors (even lower income, education and access) than US born Latinos, consistently show even better behaviors (lower smoking) and outcomes (lower mortality) than the US born. The social determinants that do have a negative effect on Latino health include assimilation and acculturation. While the population health mandate offers providers a chance to build upon the healthy behavior of Latino immigrants, current policy such as the Affordable Care Act excludes Latino immigrants in general and undocumented in particular, from program participation.