Where can undocumented immigrants go for health care?
None of the 11.2 million undocumented immigrants who the government estimates are in the country are eligible for health insurance under the Affordable Care Act. Neither are the 728,000 young unauthorized immigrants — commonly known as “Dreamers” — who are protected from deportation under the Deferred Action for Childhood Arrivals program.
A relatively small number of undocumented immigrants, perhaps in the tens of thousands, obtain health insurance through private employers. Unauthorized immigrants who are the victims of certain crimes — such as domestic violence — can apply for psychotherapy services they need in connection with that specific offense, says Yesenia Acosta, an immigration and employment attorney based in Los Angeles.
[See: How to Find the Best Mental Health Professional for You.]
Many undocumented immigrants who are college students have the option of obtaining health insurance through a student health plan. Many universities offer such plans for students who do not have insurance (some universities require students to have some form of insurance) and school officials typically do not require proof of immigration status. Five states — California, Illinois, Massachusetts, New York and Washington — and the District of Columbia offer health insurance coverage to undocumented children younger than 18. Unauthorized immigrants can also buy health insurance directly from brokers, but because they are not eligible for the subsidies provided under the Affordable Care Act, such insurance is usually prohibitively costly.
These health care options cover relatively few of the unauthorized immigrants in the country, says Daniel Ehlke, assistant professor of health policy and management at SUNY Downstate School of Public Health. To obtain health care, the vast majority of undocumented immigrants can turn to these resources for help:
1. Community health clinics. The nationwide network of about 1,400 community health clinics provides an array of basic health services, including basic dental care, to unauthorized immigrants. North County Health Services, which runs 13 health centers in northern San Diego County and one in Riverside County, California, provides treatment for diabetes, heart disease, cancer screenings, high blood pressure, tests for sexually-transmitted diseases and dental care. Officials at the health centers do not ask people for proof of immigration status, and they charge nominal fees, based on a sliding scale, for health care. Depending on the treatment and the patient’s income, officials at these clinics charge $25, $45 or $75 per service, says Irma Cota, chief executive officer of North County Health Services. The prices are slightly higher for dental care, which is more expensive. Community health clinics do not turn away patients because of an inability to pay; they treat some indigent people at no charge.
[See: Here’s How People in 8 Other Countries Stay Healthy.]
2. Free medical and dental school clinics. Many large medical schools provide free health care through clinics staffed by medical and dental students, who are supervised by physicians who are part of the university’s faculty. At a building that once housed the District of Columbia’s now-defunct public hospital, Georgetown Medical School students run the HOYA Clinic, providing health care to poor patients, including undocumented immigrants.
The facility takes patients two nights a week and provides many of the services available at community health centers, says Dr. Eileen Moore, the clinic’s medical director and associate dean for community education and advocacy at Georgetown University’s School of Medicine. The clinic treats many Hispanic immigrants from Central America, but also large numbers of patients from Africa and the Middle East, says Sarah Schuessler, a second-year medical student who volunteers at the clinic. The clinic uses a translation service to communicate with patients who speak little or no English. When they are serving such a patient, the clinic’s doctors call the service, and a translator helps the physicians and patient communicate. There are about 1,200 free clinics nationwide, according to the National Association of Free and Charitable Clinics.
3. Hospital emergency rooms. Under federal law, hospitals that receive federal funding — and most do — are required to care for patients who need emergency care, regardless of their immigration status or whether they are insured, Ehlke says. Hospital officials must provide care until the patient is stabilized, but not beyond that point. Hospitals also must develop a release plan for such patients.
For some undocumented patients, community and free clinics provide the only care available to battle a deadly disease. For example, Morena, a Salvadoran trans-woman, fled her native El Salvador in 2014 after gang members beat her twice to extort money from her and threatened her life. She arrived in the District of Columbia that year without documentation and began getting services at Whitman-Walker Health, a community health clinic in the city. A routine checkup in the summer of 2016 revealed she had contracted the HIV virus. Morena says she was devastated, but the clinic quickly provided counseling and medication, and she’s determined to fight her disease. “I don’t know what I’d do without the clinic,” says Morena, who declined to provide her real name because she fears gang members may retaliate against her relatives in El Salvador.
Community health clinics and free facilities can only serve a fraction of the undocumented population. If the government’s estimate of the number of undocumented immigrants in the country is right, there is about one community health clinic for every 85,000 unauthorized immigrants, and one free health facility for every 100,000 undocumented immigrants. While community and free clinics do a commendable job providing services to unauthorized immigrants and others, the health care resources available for undocumented immigrants are insufficient to cover the need, says Mario Russell, the director of immigrant refugee services for Catholic Charities in the Archdiocese of New York, which encompasses New York City and several nearby counties. The number of facilities that provide primary care to unauthorized immigrants is insufficient, and many immigrants don’t know where to find these resources, Russell says. Once a week, Catholic Charities in New York provides a clinic for undocumented immigrants, helping them find services, including health care. “We don’t have clinics and doctors, but we have case managers who can help people navigate access to a clinic or a hospital,” Russell says.
[See: Here’s What People Eat for Breakfast in 9 Other Countries.]
The dearth of health care options for unauthorized immigrants harms their health and costs the public more as people seek medical attention at hospital emergency rooms for conditions that might have been prevented or managed, says Gabrielle Lessard, a senior policy attorney at the Los Angeles-based National Immigration Law Center. “The lack of access to ongoing coordinated care undermines people’s ability to manage chronic conditions like diabetes and high blood pressure,” Lessard says. “This results in costly, inefficient service delivery and needless human suffering.”
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Where Can Undocumented Immigrants Go for Health Care? originally appeared on usnews.com
