Migrants often can't access US health care until they are critically ill – here are some of the barriers they face
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Friday, June 23, 2023
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“Can you tell me about cancer care for the undocumented?” I asked Henry during an interview.
Key Points:
- “Can you tell me about cancer care for the undocumented?” I asked Henry during an interview.
- He was a doctor who volunteered his time at a community-based clinic designed exclusively for low-income undocumented migrants.
- That’s what happens.” As a medical sociologist and expert in health care disparities between noncitizens and citizens, my research explores the many ways that health care and immigration collide.
- Though some states are working to challenge this, undocumented migrants remain one of the largest uninsured populations in the country.
- For low-income undocumented migrants, navigating the U.S. health care system involves a number of risks, challenges and consequences that often make them sicker.
Chilling effects: Self-denied care
- Fearing that health practitioners will out them for their legal status, many migrants decide to forego seeking care altogether.
- According to the National Immigration Law Center, most health care providers are not obligated to ask about their patients’ legal status.
- Legally, the institutions of health care and immigration are supposed to operate separately, but this could change.
- Though migrants will have the option to “decline to answer,” questions about legal status will likely be enough to deter many from seeking care.
Why IDs matter: Waiting for care
- Rodney’s case was one of many that emerged in my study about how low-income undocumented migrants navigate today’s health care system.
- When undocumented migrants cannot provide an ID, they are often denied care and begin a trajectory of exacerbated suffering.
- For some, this means having their long-term care needs relegated to private, medically unaccredited personal care homes.
- Under the current system, emergency care becomes possible for low-income undocumented migrants without an ID only after their bodies fail.
- And now, I’m waiting to die.” Health practitioners vow to “do no harm,” but when it comes to immigrant health care, the system is set up in way that legally inhibits them from “doing good.”
Medical deportation: Repatriated by hospitals
- While the term “deportation” might suggest involvement from U.S. Immigration and Customs Enforcement, border patrol officials are not involved in medical deportation.
- Hospitals facilitate medical deportation without any government oversight.
- The 1986 Emergency Medical Treatment and Active Labor Act requires hospitals to treat everyone – citizens and noncitizens – in emergency cases.
- After patients are stabilized, the law also requires hospitals to transfer or discharge patients to “appropriate” medical facilities.