“The undocumented parent may not get insurance or benefits that their citizen child is entitled to simply because they're concerned about their own immigration status,” says Jackie Vimo, advocacy director at the New York Immigration Coalition. “In other cases, they’re simply not aware that they’re even eligible for these programs.”
Vimo advocates for group markets modeled after New York’s Freelancers Union or Healthy San Francisco, a city-funded program for the poor that does not discriminate based on immigration status. Those solutions are years in the making. In the short term, undocumented adults in some states will qualify for emergency Medicaid, but only in dire circumstances.
“They'll get a Medicaid card that's only good for certain emergency services,” says Elisabeth Benjamin, vice president for health initiatives at the Community Service Society of New York. “If you get hit by a bus, or you throw your back out, or break your leg, if you have renal disease and you need renal dialysis—that kind of stuff.”
But even that narrow safety net has holes. Each month, the Mexican Consulate in New York hosts a support group for people with debilitating kidney problems. There are more than 40 regulars, but several more arrived at last month’s meeting due to recent changes in Medicaid that, according to consulate spokesman Carlos Gerardo Izzo Rivera, created “loss of access to vital medications.”
Vimo met with the group last month, and says many complained they are now only able to receive the care they need under emergency circumstances—emergencies that could otherwise be easily prevented.
“Many people who had been having dialysis medications covered for years suddenly found out the state was no longer covering it,” Vimo says. “They said that doesn't qualify as a medical emergency. But if you don't take your medications it will soon become an emergency situation—you'll be in emergency rooms and only then will emergency Medicaid kick in. It's a poor solution, both from a health point of view and financial point of view.”
Incredibly, some of the same people who left their homes behind and risked their lives crossing the border to reach the land of opportunity are now leaving because their native country offers superior health coverage. Izzo says that, in addition to advising people about resources, the consulate is also facilitating “repatriation for individuals wishing to return to Mexico and continue their healthcare alongside their families.”
That means enrolling in the country’s Seguro Popular system. Created in 2003, the public-insurance plan provides free, comprehensive healthcare to more than 50 million people. A 2008 report by the World Health Organization called it a successful example of “the democratization of health.” It is, in other words, precisely what Obamacare aspires to be.