Access to health insurance is very limited for immigrants living in the U.S. -- both undocumented immigrants and permanent residents. But a new survey has found that many U.S. adults who work on behalf of children think undocumented immigrant children should have access to healthcare equal to that of U.S.-born children.
Almost half (42 percent) of survey respondents said they agree or strongly agree that undocumented children and U.S.-born children should have equal access to healthcare, while 33 percent disagreed or strongly disagreed and 25 percent were unsure.
The survey was conducted as part of the University of Michigan National Voices Project -- a five-year study of children's opportunities funded through the W.K. Kellogg Foundation's America Healing Initiative -- in partnership with the Michigan Immigrant Rights Center. The National Voices Project surveys a unique set of people who are particularly qualified to answer questions about children's opportunities -- adults who work and/or volunteer with children.
"Partnering with the National Voices Project gave us the opportunity to see how well people who work with children on a daily basis understand what immigrant children in the U.S. face," says Susan Reed, supervising attorney at the Michigan Immigrant Rights Center. "While we saw strong support for the health and welfare of all kids, there is still significant work to be done when it comes to ensuring that immigrant children specifically have equal access to the care they need."
According to Reed, current federal policy restricts many poor noncitizen children, including all undocumented children and many children with various forms of legal immigration status, to a very limited form of Medicaid that only covers emergency treatment. Primary care and medical attention for care of chronic illnesses are not covered.
"What we're seeing right now surrounding healthcare for the immigrant population is gridlock because there are millions of children in our communities who are unable to receive necessary healthcare due to their immigration status," says Reed. "If the healthcare access issue isn't resolved, it could entrench a generation of children in poverty and health disparity."
Opinions about healthcare access for immigrant children varied among respondents from different race/ethnic backgrounds. Sixty-one percent of Hispanic respondents agreed/strongly agreed that children should have equal access to healthcare, compared with 53 percent of multi-race/other respondents, 46 percent of African American respondents, and 37 percent of non-Hispanic white respondents.
Additionally, respondents who perceived many/some racial or ethnic inequities in their communities were more likely to favor equal healthcare access for undocumented immigrant children, a finding which held true even when controlling for the race/ethnicity of people who participated in the survey.
"These findings echo what we've seen in previous National Voices Project surveys about opportunities for children and teens," says Matthew M. Davis, M.D., M.A.P.P., director of the National Voices Project and a pediatrician at the University of Michigan's C.S. Mott Children's Hospital.
"Adults who see racial or ethnic inequities in their communities tend to more favorably endorse policies that would work toward improving opportunities for the children and teens they work with," says Davis, a professor of pediatrics, internal medicine, public policy, and health management and policy at the University of Michigan and a member of the U-M Institute for Healthcare Policy and Innovation.
But for immigrant rights advocates like Susan Reed and the Michigan Immigrant Rights Center, there is much more work to be done to ensure healthcare access for the children of undocumented immigrants.
Lawful permanent resident children ("green card holders") who have held that status for less than five years are generally ineligible for the full Medicaid program, explains Reed. "Some states have exercised a federal option to provide full Medicaid coverage to lawful permanent resident children and pregnant women who have been in the U.S. for less than five years," says Reed. "Undocumented children and children who have received relief from deportation through the Deferred Action for Childhood Arrivals (DACA) program are excluded from participation in Affordable Care Act Marketplace coverage."
"Access to affordable healthcare for children in the U.S. -- both immigrant children and U.S.-born children -- is a national issue that impacts all of us," says Davis. "Providing children access to timely preventive care including vaccines, dental care, primary care, and management of chronic illnesses such as asthma has a remarkable impact on their long-term health and well-being and their ability to learn and participate in our communities."
These data are part of the fifth survey from the National Voices Project, conducted in March-April 2014.
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