New Americans make significant contributions to our nation’s health. They comprise a crucial portion of the workforce of the healthcare industry as nurses, doctors, technicians, hospice workers, and pharmacists. Too often, though, many can’t access health care for their own families. In fact, New Americans are systematically excluded from accessing health care. Though the Affordable Care Act (ACA) has expanded access, there are still barriers that disproportionately affect New Americans–and costs our government and taxpayers a lot of money.
Quality, affordable health care is a human right. New Americans are the backbone of our healthcare system and among the most disenfranchised by it. This disjuncture must be rectified. We can close the holes in our healthcare safety net by:
New Americans are far more likely than native-born individuals to lack health insurance. Barriers to health care access include laws that bar many New Americans–including but not exclusively undocumented immigrants–from federally funded programs even though they pay taxes that go towards funding them. Additionally, even for those who are eligible for health care programs, there are often barriers associated with language and cultural competency of providers, as well as in the administration of federal, state, and local health programs.
While the ACA has already done a lot of good, by providing 17.6 million Americans with quality, affordable health insurance, it has also re-entrenched some of the systemic barriers that prevent many New Americans from accessing coverage.
Notably, the 11 million undocumented immigrants living in the United States are not eligible any programs under the ACA. Undocumented immigrants pay taxes and support our social programs. Undocumented immigrants alone provided a surplus of $35.1 billion to the Medicare Trust Fund between 2000 and 2011. Once the full effect of ACA implementation is realized, at least 25 percent of the people remaining uninsured in the US will be undocumented immigrants. This significant segment of our population would be unable to see a doctor when they are sick, and would lack access to primary and preventative care that creates opportunities for them to live healthy and productive lives. Instead they are left to rely on emergency room services and free or charity care clinics. As a result of this lack of access to preventative care, undocumented immigrants are at disproportionate risk for chronic health issues like diabetes, tuberculosis, and obesity. State and local governments bear the costs of emergency visits and procedures, which can often be as expensive as more comprehensive care, but is much less effective at its primary purpose of making people healthy.
Also excluded from federally funded health programs are people who have been granted Deferred Action for Childhood Arrivals (DACA). Although the DACA program has provided important relief from deportation for many New Americans, the U.S. Department of Health and Human Services (HHS) has specifically excluded this group from insurance affordability programs, undercutting the program’s intention to support integration of qualifying individuals. There are also sticker eligibility criteria within Medicaid and the Children’s Health Insurance Program (CHIP) that exclude even more immigrants, such as those with Temporary Protected Status and U visa holders.
Even New Americans who are eligible for current programs face significant barriers. For instance, many New Americans, otherwise eligible for Medicaid, must still wait five years to apply, even though they might be paying taxes during that time, which fund services like Medicaid. Additionally, a combination of flaws in the ACA marketplaces’ enrollment processes for verifying immigration status and insufficient linguistic support make enrollment a more onerous process for many New Americans, one that too often they are unable to complete.
Such barriers are even more remarkable when we consider that New Americans comprise more than one-quarter of all physicians and surgeons in the United States, and roughly one-fifth of all nursing, psychiatric, and home health aides.
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