Immigration and Health Care Reform

By: Lee Molitoris

The United States must reform its current immigration laws, for they have a disparate impact on race and low-income immigrants.  Current immigration law discriminates against low-income individuals by screening out those that are likely to be a public charge, by capping the number of immigrants from each country, and by giving out employment visas to skilled workers rather than unskilled workers. Immigration laws have a disparate impact on race for much of the same reasons.  The U.S. receives more immigrants from Mexico, Philippines, India, and China than any other country.  Despite the higher demand, a person must wait longer to immigrate into the U.S. from Mexico, Philippines, India or China than from any other predominantly white country.  Employment visas also discriminate because unskilled workers are screened and denied entry into the U.S.

An example of discrimination against racial and indigent immigrants can be seen on the U.S./Mexico border, compared to the U.S./Canadian border.  Many people concern themselves with immigration enforcement and border patrol near the Mexico border; however, only a few discuss enforcement of the U.S./Canadian border.  Many discriminate against immigrants because of race, ethnicity, low levels of English comprehension, and many immigrants do not assimilate into the population.  Instead, many immigrants tend to live together and have no interest in learning the country’s language or customs.

U.S. health care still has many gaps that discriminate against race and indigent immigrants.  Although, government health care does provide access to indigent people, many states do not define the minimum level of care required.  Many immigrants are ineligible for Medicare due to low-paying jobs that lack health benefits.   Further, Medicare beneficiaries must pay significant co-pays and out of pocket expenses, which many indigent immigrants cannot afford.

Racial and ethnic minorities still receive substandard health care services compared to white, English-speaking Americans.  Substandard health care services can especially be seen in medical treatments and therapies, and in diagnostic testing.  Racial and ethnic discrimination in the quality of health care is due to stereotyping and biases.  Health care laws discriminate against immigrants trying to obtain health care.  Many immigrants remain uninsured because of historic racial and ethnic discrimination.  The discrimination caused African-Americans and ethnic people to remain in low-paying jobs with no health benefits.  Further, anti-immigration laws created a disparate effect and left many immigrants, who are non-U.S. citizens, without government health insurance.  Language is another factor that limits immigrants from obtaining health care.  Many government and Medicaid offices fail to provide interpreters or translated documents to immigrants who cannot speak English.  Other factors that contribute to the limited use of government health care include distrust of Western medicine, deportation, unfamiliarity with medical care, and language.  Moreover, undocumented immigrants do not have the option of obtaining health insurance from the affordable care act because of fear that even more undocumented immigrants would flee to the U.S. in an effort to benefit from free healthcare.

Congress has not enacted any reform to address these issues in immigration and health care.  One possibility could include visas for unskilled workers that incorporate an educational component.  This type of reform would also help deter future discrimination as citizens would be able to socialize and learn with immigrants of different racial, ethnic, and economic backgrounds.  This type of reform would also help to assimilate immigrants by teaching them English and U.S. customs, thus providing a better chance of obtaining health care.

Sources:

Kevin R. Johnson, The Intersection of Race and Class in U.S. Immigration Law and Enforcement, 72 Law & Contemp. Probs. 1, 12 (2009).

Kevin R. Johnson, Fear of an “Alien Nation”: Race, Immigration, and Immigrants, 7 Stan. L. & Pol’y Rev. 111, 115 (1996).

Brietta R. Clark, Hospital Flight from Minority Communities: How Our Existing Civil Rights Framework Fosters Racial Inequality in Healthcare, 9 DePaul J. Health Care L. 1023, 1046 (2005).

Rose Cuison Villazor, Community Lawyering: An Approach to Addressing Inequalities in Access to Health Care for Poor, of Color and Immigrant Communities, 8 N.Y.U. J. Legis. & Pub. Pol’y 35, 41 (2005).

Walter L. Stiehm, Poverty Law: Access to Healthcare and Barriers to the Poor, 4 Quinnipiac Health L.J. 279, 301 (2001).

Julianne Zuber, Healthcare for the Undocumented: Solving a Public Health Crisis in the U.S., 28 J. Contemp. Health L. & Pol’y 350, 352 (2012).

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