Empowering Immigrant Communities: Resilience Strategies

Unlike citizens, most noncitizens face obstacles to accessing private health coverage due to eligibility restrictions for employer-sponsored coverage and the ACA marketplace. The Biden Administration has made changes to public charge policy and nurs fpx 4010 assessment 2  increased investments in outreach and enrollment assistance, but addressing barriers will take time. HMS students founded Quetzales de Salud, a resource gathering team of students that identified COVID-19 testing sites and health care providers that do not discriminate based on immigration status.

In the United States, a patient’s access to care depends on many factors, including: health coverage; financial support for healthcare services; and quality and availability of healthcare providers. While coverage alone is not enough to ensure access, it can provide a gateway into the health care system and reduce barriers that inhibit a patient’s ability to seek care. Poverty levels may also limit a person’s access to care, not just because they cannot afford  take my online course for me the cost of healthcare, but because they are unable or unwilling to seek it due to the many other factors that contribute to poor health, such as not eating enough healthy food or using drugs or alcohol.

Immigrant communities are even more discouraged from seeking health care services and accessing coverage, especially since late 2016 when the federal government rolled out new enforcement initiatives such as broad deportation authority, a revamped public charge rule, and attempts to end Temporary Protective Status and DACA. HCFA and partners such as MIRA, HLA and the Massachusetts Law Reform Institute are working to nurs fpx 4900 assessment 4  educate advocates, service providers, and immigrant communities about these policies. People with any lawfully present immigration status may enroll in the ACA Marketplace plans and receive premium tax credits. They must meet all other ACA enrollment requirements, including the individual mandate and related penalty (exempt if low-income or meet specific exemptions). People with COFA status are also eligible for Medicaid and CHIP coverage in states that choose to expand their eligibility.

The ACA made premium tax credits available to help pay for marketplace coverage to everyone with incomes below 400 percent of the poverty level. Congress increased the maximum income threshold and expanded availability of those subsidies through ARPA and the Inflation Reduction Act, effective through 2025. To apply for premium tax credits, consumers attest to their immigration status using a list of acceptable documents. The ACA Marketplace tool provides  ethical and policy factors in care coordination  a calculator that estimates the cost of marketplace coverage and whether a person will qualify for a subsidy. In some states, individuals can get state-funded premium subsidies to purchase coverage outside the ACA Marketplaces.

Currently, most children in immigrant families lack health coverage. In 1999, nearly one-third of low-income children in families with legal immigrant parents lacked insurance, compared to just 20 percent of such children in native-born parent families. State policy on immigration status can have a major impact on child coverage. In states with restrictive policies, children from immigrant families are more likely to be uninsured than in those root cause analysis and safety improvement plan without restrictions. In addition to Medicaid and SCHIP, some states offer private health insurance to children regardless of their mother’s documentation status. However, these private plans generally do not qualify for federal subsidies to make them affordable, and can be expensive.