Despite Obamacare Gains, Undocumented Immigrants Largely Excluded

Health care reform supporters in Minnesota - Photo: AFL-CIO/Flickr

Health care reform supporters in Minnesota; photo: AFL-CIO/Flickr

By Patricia Guadalupe, originally published by NewsTaco.

Marta Jiménez counts herself as one of the lucky ones. Marta, who asked not to use her real name because she is undocumented, first came to Washington, D.C. from Central America nearly 30 years ago on a tourist visa and overstayed.  Eventually she married a fellow undocumented immigrant and raised three daughters born in the United States who are now adults and on their own. Marta gets by with money from babysitting and cleaning houses after a divorce ten years ago left her with little means of support. She is hampered by her very limited English skills that leave her with few options.

Marta has some health issues, including a bad back and bad knees aggravated by a fall down a flight of stairs several years ago, but she says she’s lucky because even though she’s undocumented she has health insurance. Lucky indeed, because many Latinos – whether they be citizens, legal residents or undocumented immigrants – have no insurance at all.

Hispanics comprise the largest share of the uninsured among all groups in the United States – more than 12 million Latino adults and close to three million Latino children have no medical coverage.

Check out earlier coverage of Obamacare and immigrants in New York.

The undocumented don’t qualify for Obamacare.

More than 50 million Latinos live in the United States, making them the fastest-growing population group in the country. The Urban Institute and the Pew Hispanic Center calculate that 36 percent of Latinos in the United States are immigrants, and of those 24% are undocumented.

Because Marta is undocumented, she doesn’t qualify to participate in the federal Affordable Care Act, more commonly known as Obamacare. Negotiators of that landmark legislation have said they felt they needed to make that concession – exclusion of undocumented immigrants – in order for it to pass and benefit a far greater number of people than it was going to leave out. But that means millions – approximately 12 million undocumented immigrants live in the United States — all across the country have to fend for themselves when it comes to healthcare. For low-income Latinos – especially among the undocumented population – that means not being able even to participate in Medicaid, the government’s healthcare program for the poor.

While Obamacare mandates that Medicaid coverage be expanded to cover families up to 133 percent of poverty guidelines, and health subsidies be provided to help families with incomes up to 400% of poverty guidelines, undocumented immigrants can’t avail themselves of that coverage.

Nothing changed for the undocumented.

“For undocumented immigrants, nothing has changed under Obamacare,” said Barrie Lynn Tapia, an attorney and former social worker in Washington, D.C., who works with underserved communities.

Additionally, not only are undocumented immigrants prohibited from receiving tax subsidies under Obamacare, they can’t purchase any coverage under the law even if they pay full price out of their own pocket.

Just a handful of states and Washington, D.C., offer healthcare coverage to undocumented immigrants. In the nation’s capital, the program is called D.C. Healthcare Alliance, which is run by the city and has become the de facto healthcare provider for undocumented residents. Marta Jiménez joined the Alliance nearly ten years ago and visits participating community clinics throughout the city for a variety of health needs.

“They (the Alliance) pay for everything, and there is no deductible. I honestly don’t think I would’ve gotten a better deal under Obamacare even if I could qualify,” she says. “I am very grateful that I live in a city that cares about its people, even those without papers, and that they help me in Spanish.”

Community clinics matter.

If an undocumented immigrant lives elsewhere, what are they to do? For many undocumented immigrants, the hospital emergency room has been the only option, but for routine medical care, this is where community healthcare clinics are stepping in to help undocumented immigrants get the medical attention they need.

And that’s where community healthcare clinics are stepping in to help undocumented immigrants get the medical attention they need. There are also what are called Federally Qualified Health Centers, community health centers that receive some federal funding under ACA. They provide a wide variety of services, from primary care to dental to mental health.

“Today, uninsured individuals, including many uninsured immigrants, often rely on community health centers and clinics for their care. Safety-net providers are seen as a trusted source for care, and are able to offer culturally and linguistically appropriate services that meet the needs of diverse populations,” says a report from the Kaiser Family Foundation. “Under the ACA, these providers will likely remain a primary source of care for millions (including) non-citizens who remain uninsured after 2014.”

Fi2W is supported by the David and Katherine Moore Family Foundation and the Ralph E. Odgen Foundation.

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Feet in 2 Worlds (Fi2W) is an independent media outlet, journalism training program, and launchpad for emerging immigrant journalists and media makers of color. Our work brings positive and meaningful change to America's newsrooms and has a broader impact on how immigration is reported and the ethnic and racial composition of news organizations.