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Undocumented Immigrants and the Health Care System


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Undocumented immigrants' health can suffer simply as a result of their undocumented status. Undocumented people are more likely to be uninsured, with nearly half of all non-elderly adults and one-third of children uninsured. In fact, they have the lowest rates of health-care coverage in the entire United States. This is because they are ineligible to enroll in Medicare, Medicaid, CHIP, or purchase coverage through the ACA marketplaces. This includes individuals with DACA as they are not considered to be lawfully present and thus are not eligible.


Undocumented immigrants experience harmful delays in care, rely on more short-term care, and have poor health outcomes as a result of their lack of coverage. Due to their lower utilization of care, undocumented immigrants often do not receive preventative care, resulting in worse health outcomes that are more difficult and expensive to treat. While some people will avoid going to the doctor entirely because they do not want to deal with the high costs, others will avoid going to the emergency room until they are critically ill. Another significant barrier to accessing health care is the fear of being asked about their citizenship status. They do not want to risk being deported by seeking medical attention.


It is important for undocumented immigrants to know where they can turn to for help. Although they do have limited options for affordable health care, some cities and states have developed programs to provide them with low-cost or no-cost primary and specialist care. Undocumented immigrants may also be able to receive low-cost care at community health centers. One disadvantage is that this care is often limited to mainly preventative and basic care, making specialty services more difficult to access. They can also access family planning and basic reproductive health care at Title X clinics. Planned Parenthood, for example, charges patients based on their income, regardless of immigration status or health insurance coverage. Finally, uninsured undocumented immigrants do have access to emergency medical care. Federal law requires that hospitals provide screening and stabilization services to anyone who comes into the emergency room, regardless of their insurance or residency status.


Undocumented immigrants can obtain health insurance through student health plans, employer-sponsored coverage, and private health care plans purchased off-exchange. However, access to employer sponsored coverage is limited as undocumented immigrants are often employed in low-wage jobs that do not offer this kind of coverage. Furthermore, because undocumented immigrants are more likely to be low-income, they may be unable to afford this coverage even if it is available. Some states have implemented their own programs to cover undocumented immigrants, particularly pregnant women, and children. As of 2019, 16 states have opted to provide prenatal care to women regardless of their immigration status by extending CHIP to the unborn child. Similarly, six states and Washington, DC currently use state funds to cover children regardless of their immigration status if they meet income requirements.