Amanda Pierce / Lantern photographer
While the great health care debate rages in Washington, D.C., there is at least one group at risk of being forgotten, according to a speaker that visited Ohio State’s campus: legal immigrants to the United States.
Randy Capps of the Migration Policy Institute lead a discussion on immigration and health care reform Tuesday at OSU’s Townshend Hall, highlighting the fact that current policy, which bars many legal immigrants from participation in Medicaid, leaves large numbers of people uninsured.
The event, which took place from 12:30 p.m. to 1:30 p.m., attracted about 30 people to a presentation that was split between a half-hour lecture and half-hour discussion.
A main interest to the crowd was a 1996 act that prevents lawful permanent residents from participating in Medicaid. According to the law, one must be a resident for five years in order to be eligible for health care.
“They could and should remove this five-year bar,” Capps said. “These are immigrants who’ve got a green card and who were allowed to come in with the blessing of the U.S. government.”
Capps said of the 12 million legal permanent residents in the U.S., about 37 percent were uninsured in 2007. This leaves a large and expensive burden on the health care system when these people have to go to the emergency room to receive any type of care, Capps said.
Some members of the crowd questioned Capps extensively on the effects of the considered employer and individual mandates; requirements that all Americans, and many businesses, purchase health insurance. Capps said if these mandates are not implemented, the effect might be detrimental to many low-income immigrants whose places of work do not provide health care.
“Legal immigrants are lower income and less likely to already have health insurance,” Capps said. “The expansion of Medicaid is a big deal, and the individual mandate is a big deal, because they are less likely to have coverage because they can’t afford it.”
Student reactions to the debate were varied and strongly opinionated, but some also gave credence to Capps’ speech.
“Obviously something needs to happen. There needs to be a change,” said David Ellsworth, a first-year master’s student in public health. “I think it would benefit society if immigrants could be considered in these pools because the new system relies on more people being included in these pools, and this would be a good way to include people.”
The issue of whether or not to extend Medicaid coverage to even documented immigrants, however, was recognized as a difficult political and logistical issue.
“It’s kind of a weird balance of we’re going to be taxing our resources and that expanding it would do well in the public health sense, and personally I would be an advocate for it, but finding a means to do so would be challenging,” Ellsworth said.
Other students said the topic of legal immigrant health care is difficult.
“I think it’s very complicated. It’s not the same as covering low-income Americans with insurance because the immigrants are unstable. Maybe they will go back to their countries later,” said Yun Zhang, a student in sociology.
Zhang said she understood the difficulty of dealing with insurance as a non-citizen in the U.S.
“The charges in Chinese hospitals are not so high,” she said. “If I’m injured or I’m sick, I go to the hospital without hesitation, but I will consider how much it will cost me when I’m in America, because the doctors and the hospitals charge so much money.”
In the end, however, Capps said he was concerned with the future of health care reform in the country. The biggest problem, he said, is the weakening of the Medicaid system through a lack of funding.
“Medicaid has suffered a lot of cuts at the state level,” Capps said. “States have been cutting reimbursement rates, and quality of health care is worse than a few years ago. It’s going to get more expensive, so I think some more attention must be paid to that program.”
Capps said the current debate leaves doors open for improvement. If the government is willing to put in the effort to properly plan out the coming reform process, then immigrants might be covered.
“Ultimately it comes down to some way to control cost while ensuring access to health care,” Capps said. “And that’s getting harder and harder in the budget climate.”