The Covert Realities of Immigrant Healthcare

BY GRACE KANG

With the new President, there are clear sentiments of fear within many minority populations. One of the most feared of these groups is the illegal immigrant and refugee population. During and prior to the election season, major news journals failed to cover the realities of the healthcare received by immigrants and its effects on American economics, health, and politics.

The Affordable Care Act has received a great amount of attention since President Donald Trump started to transition into office. For example, a segment of Paul Ryan’s Town Hall went viral when he was confronted by a cancer patient who claimed that Obamacare saved his life.¹ Without a clear course of action in terms of replacing the Affordable Care Act, many Americans fear what the path to healthcare may look like and, thus, this topic has received national scrutiny.

The nation failed to garner the same level of scrutiny, however, for the cross section between immigration and healthcare. Do illegal immigrants receive some sort of aid from the government to help fund their healthcare? How long will refugees be able to rely on the US government to help provide them the necessary medical assistance? What sort of impact does the refugee and immigrant populations play in the US economy of healthcare? Do immigrants really bring in fatal diseases into this country?

One of Trump’s major reasons for blocking the border is based on the notion that “tremendous infectious [diseases are] pouring across the border.”² He added that “The United States has become a dumping ground for Mexico and, in fact, for many other parts of the world.”² This notion of diseased undocumented immigrants stretches much further than Trump. Representative Phil Gingrey, R-Ga. claimed that there were reports of undocumented minors reaching the border “carrying deadly diseases such as … Ebola virus.”² Not only did the Ebola outbreak take place in Africa, but once Trump and Gingrey were fact-checked by Arthur Caplan, the director of the division of medical ethics at New York University’s Langone Medical Center, Caplan found that, “there [was] no evidence whatsoever that this [was] so.” In fact, he claims that there is, “No study or survey [that] shows this. There is no outbreak or bump in disease attributable to immigrants.”²

As for immigrants and refugees who come through the legal process, the Centers for Disease Control and Prevention tracks and reports diseases, comes up with responses to potential disease outbreaks, advises organizations and countries who partner with the US on behalf of refugee groups, provides guidelines for disease screenings, and educates and communicates with immigrant and refugee groups and partners to make sure that the potential for disease outbreaks remain as minimal as possible.³ Needless-to-say, the Centers for Disease Control and Prevention works to the best of their ability to establish precautionary measures to make sure that the people in the United States are protected from the spread of foreign diseases.

What many avid critics of government funded healthcare as well as immigration fail to mention is the economic impact refugees and undocumented people have in the US healthcare systems. According to the Journal of General Internal Medicine, undocumented immigrants provided a surplus of 35.1 billion dollars to the Medicare Trust Fund.⁴ Since they are not covered by the Affordable Care Act, unlike refugees, undocumented immigrants end up spending much more on health care.⁵ This is caused by a multitude of reasons beyond just the fact that most undocumented people do not have access to healthcare. Immigrants, especially those who are Hispanic, are disproportionately exposed to dangerous jobs.⁶ In fact, the occupational fatality rate for Hispanics have been the highest among all groups in the United States for fifteen years.⁶ The socioeconomic level that undocumented immigrants are in are often associated with greater risks for health outbreaks. Combine these factors with a lack of health insurance and it is inevitable that undocumented immigrants experience low quality care, more emergency room visits, and higher rates of spending. As immigrants keep themselves busy working, they unintentionally allow minor health problems to become major health issues that need immediate and acute medical attention.

Many people cringe at the thought of the government providing undocumented immigrants and refugees health insurance. After all, why should we, the taxpayers, pay for a person who couldn’t even wait in line to enter this country? The common argument against providing health care to undocumented populations has to do with the notion that since they’ve broken the law, they deserve to be punished.⁷ An important thing to realize here is that part of that punishment involves denying them health care services.

In response to this antagonization of the Republican party and conservative ideals, Republicans supported the Emergency Medical Treatment and Active Labor Act. It required that anyone coming to an emergency department must be stabilized and treated, regardless of their insurance status or ability to pay.⁸ Interestingly enough, this has remained an unfunded mandate since 1986 when the bill was first signed into law by Ronald Reagan.⁸ Ever since this law was created, Republicans have routinely cited the EMTALA as a key example that the US already has “de facto national health insurance” and does not need further government involvement in health care.⁹ For example, George W. Bush in 2007 claimed that, “People have access to health care in America. After all, you just go to an emergency room.”⁹

Little do people know, we are already paying for medical treatments for many immigrants and refugees. EMTALA states that if the patient, which includes illegal immigrant patients as well, sought help from emergency hospitals but cannot afford the treatment, the Federal government, State government, hospital, and the American consumers absorb the costs.⁷ Since the government is not doing its part in funding this mandate, the hospital and American consumers are the ones who end up absorbing most of the cost. In fact, the burden of uncompensated care has caused many emergency departments to close and in turn has decreased the resources for everyone in need of emergency care.⁸

The refugee and undocumented populations in this country make up the forefront of politics, but, in some ways, are also left forgotten in the dust. There are many people who are fighting against mass deportation in this country. However, in that battle, there also needs to be people who are fighting for the basic human rights for undocumented and refugee populations in this country. There’s no point in fighting to keep the immigrants here if we as a nation are not doing our part to provide them with the necessary medical attention they need or will need in the future.

Grace Kang is a sophomore in Saybrook College majoring in Applied Mathematics. She can be contacted at grace.kang@yale.edu.

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References:

1. Culp-Ressler, T. (2017, January 13). Paul Ryan confronted by cancer patient who says Obamacare saved his life. Think Progress. Retrieved from https://thinkprogress.org/paul-ryan-cancer-patient-obamacare-fa648a3d738e#.x8rrt3vsu.
2. Jacobson, L. (2016, July 23). Are illegal immigrants bringing ‘tremendous’ disease across the border, as Trump says? Unlikely. Retrieved from http://www.politifact.com/truth-o-meter/article/2015/jul/23/are-illegal-immigrants-bringing-tremendous-diseas/.
3. Immigrant and Refugee Health. (n.d.). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/immigrantrefugeehealth/.
4. Lauer, G. (2015, June 29). Undocumented immigrants help keep Medicare solvent, according to new study. Retrieved from http://www.pnhp.org/news/2015/june/undocumented-immigrants-help-keep-medicare-solvent-according-to-new-study.
5. Affordable Care Act. (n.d.). Refugee Health Technical Assistance Center. Retrieved from http://refugeehealthta.org/access-to-care/affordable-care-act/.
6. Zuehlke, E. (2009 November). Immigrants Work in Riskier and More Dangerous Jobs in the United States. Population Reference Bureau. Retrieved from http://www.prb.org/Publications/Articles/2009/usimmigrantsriskyjobs.aspx.
7. Mukherjee, S. (2013, May 24). Why Undocumented Immigrants Should Have Access To Taxpayer-Funded Health Care. Think Progress. Retrieved from https://thinkprogress.org/why-undocumented-immigrants-should-have-access-to-taxpayer-funded-health-care-b7dd725b617f#.kemugp6z3.
8. (n.d.). American College of Emergency Physicians. Retrieved from https://www.acep.org/news-media-top-banner/emtala/.
9. Bartlett, B. (2012, October 25). Mandates, ERs and EMTALA: Republicans’ Dilemma. Progressive Organizing in Metrowest (South). Retrieved from https://progressivemetrowestsouth.wordpress.com/2012/10/25/mandates-ers-and-emtala-republicans-dilemma-bruce-bartlett/.