Will Healthcare Reform Be Fair to Immigrants?
| July 28, 2009
For reform to work, argues the author, it must fully include immigrant communities, whose members already struggle to afford decent medical care in the United States.
President Obama’s healthcare plan is promising. Yet, it draws concerns from the immigrant community—especially at a time when the Massachusetts Senate, in an effort to close a growing deficit, has passed a state budget that eliminates coverage for 28,000 legal immigrants.
The first and foremost concern is the disparity in treatment experienced by racial and ethnic minorities in the current healthcare system, documented by the 2002 Congressionally mandated report by the Institute of Medicine. The study, Unequal Treatment, found that members of minorities received poorer care even when they had the same incomes, insurance coverage and medical conditions as whites. What protection is there to ensure against Obama’s public insurance option falling prey to those same discriminatory factors?
The second worry is the issue of immediate accessibility. Ever since welfare reform was enacted in the mid-nineties, newly arriving immigrant families must wait five years for federal health benefits under Medicaid, the chief provider of health insurance to immigrant women. While immigrant women may access emergency services pertinent to labor and childbirth, there are no provisions for prenatal and postpartum care and family planning services, which are financed by their tax dollars.
"If reform is going to work and reduce costs for all Americans,” says Sonal Ambegaokar, health policy attorney for the National Immigration Law Center, it “must be inclusive and must end the unfair treatment of immigrants.” Few people are even talking about the economic and social welfare effects of leaving undocumented workers uncovered and forced to rely on expensive emergency care.
And last but not least, while it’s hard to imagine reaching universal coverage with any plan that uses employer-based healthcare insurance without requiring that businesses provide benefits or contribute to a public fund, the effect of such mandating provisions on small businesses concerns immigrant workers. To the extent that these employers feel they must lay off workers, immigrant communities would be among the first to suffer.
In New Jersey, for example—one of the most ethnically diverse states in the country—the “number of people who are provided insurance through small staff size companies has shrunk by 111,667 in the last 10 years, including 36,000 in 2008 alone,” according to New Jersey’s Department of Banking & Insurance. Proposed subsidies to help low-income families and measures to aid small businesses need to be sufficient to offset such damaging effects.
In addition to the monetary impact, loss of jobs and health coverage can also cripple the emotional health of immigrant women who see themselves as resources for their families. In fact, a qualitative study on immigrant women’s health suggests that “the family-centeredness of immigrant women's well-being is a mediating factor in all aspects of their [own] health.”
Immigrant communities in Massachusetts are hoping that state legislators approve a $70 refund for health care proposed by Governor Deval Patrick. Similarly, expectations run high across the nation. All eyes are on President Obama to ensure equity in healthcare because he stands before us as a testament to equal rights for all in the United States of America.