It’s a real pain when you call the doctor’s office and can’t be seen for ten days. Now imagine being told that the wait will be ten years. That’s what immigrants in the United States are facing, particularly immigrant women, as immigration and health care reform laws leave them behind and create a potentially lethal gap between coverage and the people who need it. Organizations like the National Latina Institute for Reproductive Health are coming out swinging, arguing that no one should have to wait ten years — or even 15, in some cases — for health care.
Here’s how the current framework of immigration reform would work, as proposed under the bill in Congress: the path to citizenship starts with 10 years of “Registered Provisional Immigrant” status. During that time, immigrants pay taxes, pay fines and otherwise contribute into governmental systems in the United States. One thing they can’t do? Qualify for means-tested healthcare benefits such as Medicare, or receive assistance in the form of tax credits and subsidies to help them access health insurance exchanges.
Once this probationary period is up, immigrants may apply for citizenship and have up to five years to apply for Medicare if they need it. It could potentially take up to 15 years to complete application and enrollment in these programs to access health care in the United States, and this is a very, very long time to wait. Obviously any acute conditions are going to reach the critical point long before patients can see a doctor, and issues like slow-growing tumors and chronic health conditions will have plenty of time to flourish while low-income patients struggle to pull together the money to see a doctor, or wait for benefits eligibility.
While the goal for all immigrants is economic success and wellbeing, such that they could access benefits through employment or be able to buy into health insurance plans, this unfortunately isn’t the case. Immigrants in the United States often work in low-wage jobs for employers who do not offer benefits of any kind, making the social safety net critical for them. Women and children in particular across the United States, regardless of immigration status, are more likely to live in poverty, and that problem is intensified for immigrants.
Lack of access to health care can have serious consequences for patients, exacerbating disabilities and sometimes leading to fatal complications. It’s also bad for the economy, because unhealthy people can’t work as efficiently, and they run the risk of passing on illnesses to others, as well. That’s a bad combination, and one that could be easily addressed by ensuring that all people can access means-tested benefits to ensure that the poorest residents of the country can get the health services they need. After all, immigrants are paying into the system, but they’re not taking anything out of it; effectively, they’re subsidizing low-income U.S. citizens for no return on their investment.
In addition to being an economic and social problem, this is a human rights issue. U.S. hospitals pledge to provide emergency care (including labor and delivery care) to anyone regardless of immigration status and health insurance coverage, but the need for health care doesn’t stop there. Preventative care including management of ongoing chronic health conditions is an important part of a holistic health care system, and it’s an aspect of the current system that’s notably lacking.
For immigrant women, 15 years is too long to wait. The society, communities and families all win when people get the health care they need, when they need it.
Photo credit: Seattle Municipal Archives.