Some First Steps Proposed to Help Undocumented People Access Health Care

This is a guest blog from Jonathan Gonzalez-Cruz, Policy Coordinator, CT Students for a Dream

Like most people I looked forward to my 18th birthday, excited to finally become an “adult” and enjoy the freedoms it came with. But what should have been a day overflowing with happiness was flooded with sorrow and tears instead.

On my 18th birthday I accompanied my mom to have her lungs checked by a doctor. For several months, her lungs were in pain and agony. As her appointment was finishing, I stood in the hallway, heartbreakingly watching my mom cry an endless stream of tears after being told there was nothing doctors could do to help her. She did not have health insurance, due to being an undocumented mother, nor could we afford to pay the out-of-pocket expenses of the treatments’ cost.

Despite being inside a health care facility full of health professionals specializing in treating people like my mom, accessing the necessary care was impossible. Unfortunately, my mom’s experience is not an isolated case, but rather the norm in undocumented communities across the state and country.

Undocumented individuals have limited options for health care coverage

Simply put, undocumented individuals are heavily barred from accessing health insurance. With an estimated 130,000 undocumented population in our state, this is a massive public health concern. An inability to access insurance today translates to an inability to access care, and an inability to access care causes people’s health issues to develop into more serious, harmful life-threatening conditions.

In Connecticut, there are only two effective ways an undocumented individual could purchase health insurance, but realistically, both are limiting:

• Opt into a University’s health insurance plan, if one is a full-time student,
• Through one’s employer, if one is able to be legally employed.

Purchasing a university’s insurance plan is simply unaffordable for most students. Currently, undocumented students pay in-state tuition completely out of pocket due to being ineligible to receive financial aid — and university health insurance plans cost roughly an additional $3,000 per year. And, unless an individual is one of 8,500 DACA recipients in our state who have a work permit and who can legally work, getting an employer’s insurance plan is impossible for most.

Additional challenges to health insurance access

Additional challenges that bar undocumented individuals from getting healthcare are set at the federal and private level. Under the Affordable Care Act, undocumented immigrants are specifically excluded from the law. This means they cannot purchase insurance plans through the state health exchanges (Access Health CT in Connecticut).

Undocumented immigrants are also not eligible for Medicare and Medicaid programs. Then, in the private sector, it is common practice for insurance companies to not offer health insurance plans to undocumented individuals.

A moral and economic issue

Altogether, undocumented immigrants have a disproportionately difficult time accessing health insurance in Connecticut. And in today’s health care system, lack of health insurance translates to lack of health care.

As a result, countless undocumented families suffer the excruciating choice between putting food on the table or paying to go to the doctors, their medication, their treatment, and so on.  Unfortunately, most make the sacrifice of not being treated and their health issues ultimately develop into worse conditions and symptoms that, with time, could and do become life-threatening.

Furthermore, lack of coverage is an economic issue. Because hospital emergency rooms treat medical emergencies regardless of insurance coverage, the uncompensated care costs are distributed across both the public and private sectors, including the state and local governments.

Additionally, covering individuals and allowing them to seek early and preventative treatment is a cost-saving method as treating issues early on cost less than treating them once they are developed. Fortunately, we can fix both the public health and economic issues rooted in lack of insurance coverage.

What can be done

In Connecticut, we must work to equalize access to affordable health insurance regardless of immigration status. Ultimately, the solution is to open eligibility to state health programs that make accessing affordable insurance possible as it is fair and just. In 2014, undocumented taxpayers collectively paid an estimated 145.2 million in state and local taxes, 252.7 million in federal taxes, and contributed 54.6 million into Medicare.

As a result, undocumented taxpayers annually contribute to state health programs that make accessing health insurance affordable; however, due to one’s immigration status, they are unable to access the very same programs they fund. As taxpayers funding state health programs, undocumented residents deserve an equal and fair opportunity to access them.

A first step — Buying private insurance

A first step to equalizing health insurance access is occurring this 2019 legislative session. In the Connecticut Legislature, CT Students for a Dream, a statewide organization fighting for the rights of immigrants, is supporting H.B. 6093: An Act Concerning Consideration of Immigration Status by Health Carriers, a bill that would prohibit health insurance carriers from discriminating against individuals based on immigration status. Effectively, this would allow for individuals to purchase private insurance plans for themselves and their families.

However, as most people can vouch for, health insurance premiums and deductibles make it both expensive and unaffordable. In turn, although the bill is an initial step, it is certainly not the last, as it does not address the core issue of affordability and accessibility for many low income immigrant families.

Public option: Promising development for health coverage

Another first step is to allow undocumented individuals to be eligible for H.B. 7267: An Act Concerning Public Options For Health Care in Connecticut, a bill that would create a public option in Connecticut. A public option is health insurance provided by the government, in this instance the state, that would be more affordable compared to insurance from the private sector.

Allowing undocumented immigrants to be eligible for a future public option is imperative to ensuring people have access to affordable insurance; however, we must continually advocate for the inclusion of the undocumented community while this bill takes shape.

During the creation of the Affordable Care Act, undocumented individuals were discarded from being eligible due to bipartisan compromise. Learning from the history of the ACA, here in Connecticut we must ensure we are not treating undocumented individuals as bargaining chips traded around for votes. Instead, we must ensure the undocumented community is treated with humanity and fairness by allowing individuals to be eligible for a Connecticut public option. This will make a significant impact on undocumented individuals and their families abilities to access affordable health insurance.

But we need to go further

Without access to affordable and accessible programs the actual impact of these proposals will be limited.  Our current health insurance and health care system is broken – the fact that immigrants are left out of our current system is a symptom of that. What is truly needed is universal health care for all our state’s residents, regardless of status and ability to pay. Without universal health care, we will be leaving out the most marginalized and vulnerable segments of our population.