The United States is among the nations with a significant population of immigrants globally. According to a recent report by the Kaiser Family Foundation, there were 45.5 million individuals who had moved to the country for various reasons in 2022. The number accounts for 21.2 million noncitizens and 24.2 million naturalized citizens, representing approximately 7% of the United States’ population (The Kaiser Family Foundation, 2023). The population is projected to rise since many individuals and groups from each corner of the world still believe in the ‘American dream.’ However, unlike American citizens, immigrants face significant social and economic problems, jeopardizing their quality of life and overall well-being. Health is one of the primary areas in which this group experiences disparities. Immigrants residing in America experience substantial obstacles in acquiring health insurance and soliciting medical care due to fears linked to legal status, highlighting the urgent need for robust intervention mechanisms.
Barriers
While the hesitance or refusal among immigrants in the United States to seek vital medical assistance is associated with multiple issues, legal status plays a substantial role in increasing the barriers and disparities. As per Alarcon (2022), unregistered immigrants are discouraged by the pervasive fear of deportation. They find some measures enacted by the United States Department of Immigration and Customs Enforce, like raids and detention, unbearable (Philbin et al., 2018). Additionally, immigrants are more prone to language barriers. Abbas et al. (2018) argue that individuals with limited English proficiency are forced to depend on community health centers or clinics for healthcare services. Due to ineffective communication with healthcare providers, immigrants could shy away from soliciting necessary medical aid. Moreover, the legal statutes evoke a sense of discrimination in the context of health in the United States. Insights from Funk and Lopez (2022) and Pillai et al. (2023) showcase unfair treatment and extreme difficulties among the Black, Hispanic, and Asian communities in accessing quality and safe care.
Challenges
Health coverage among the immigrants in the United States is minimal. Several sources and studies unveil a significant gap in insurance among non-Americans and native-born populations due to the aforementioned barriers. For example, Hispanic Americans are among the affected minority groups. Funk and Lopez (2022) argue that members from this group are more than twice as likely to lack health insurance coverage as privileged populations. Also, Pillai et al. (2023) insist that about half of the undocumented immigrant adults are not medically covered. The number is vast compared to less than one in ten citizens without coverage. These disparities are attributed to broader social, economic, and political problems (Chang, 2019). Immigration status, eligibility requirements, and income levels are among the leading challenges endured by non-Americans in accessing quality and safe care.
Since immigration status matters a lot in establishing the groups eligible for health insurance in the United States, undocumented immigrants are directly and inadvertently excluded from federally funded coverage programs like the Affordable Care Act and Medicaid. According to Pillai et al. (2023), the marketplace is so complex that even sometimes lawfully present immigrants are driven away by massive waiting periods and eligibility restrictions. Eligibility bottlenecks for federally funded coverage programs further compound the issue. Besides, the efforts of immigrants to get covered and access quality care are hampered by their income levels. Pillai et al. (2023) reveal that immigrant adults with annual income below $40,000 are disproportionately uninsured compared to individuals from a higher socio-economic bracket. As a result, the immigrants cannot afford the existing private health insurance schemes.
The fact that the immigrants are less insured exacerbates their health outcomes and financial well-being. According to Funk and Lopez (2022), uninsured immigrants are unlikely to receive timely medical care and preventive services. The authors posit that those with inadequate English proficiency or legal status concerns occasionally hesitate to solicit medical assistance. Furthermore, Pillai et al. (2023) link increased financial risks with limited health coverage among non-Americans due to paying out-of-pocket costs for medical services, medications, and emergency care. Ultimately, the situation drives cycles of poverty and economic instability within immigrant communities.
Solutions
The high incidence of uninsured immigrants in the United States and the potential dire implications on their health and well-being call for relevant stakeholders to adopt robust solutions. The complex and multifaceted nature of the issue necessitates a holistic approach encompassing policy reformation, financial assistance, education promotion, and bolstering language acquisition and coverage. Hacker et al. (2015) recommend federal policy changes to increase Medicaid coverage and equitable health access to immigrants. Alarcon (2022) suggests providing financial assistance and subsidies to aid low-income immigrants in meeting the prevailing health insurance premiums. Besides, outreach, education, and language development programs are viable alternatives to address the factors perpetuating health disparities among the immigrant populations.
Conclusion
Immigrants living in America endure vast barriers in obtaining health insurance and soliciting medical care due to legal status and other fears, underscoring the urgent need to intervene and improve their outcomes. The barriers emanating from legal status are intertwined with challenges in immigration, language proficiency, and income levels, which substantially hamper immigrants’ access to quality healthcare. Ultimately, the situation increases health inequities and drives monotonous cycles of poverty. Relevant stakeholders are recommended to intervene through policy reforms, financial assistance initiatives, and practical education and outreach programs to promote health literacy and language acquisition. It is imperative to boost the health and well-being of the immigrant population in the United States by striving to achieve health equity.
References
Abbas, M., Aloudat, T., Bartolomei, J., Carballo, M., Durieux-Paillard, S., Gabus, L., & Pittet, D. (2018). Migrant and refugee populations: A public health and policy perspective on a continuing global crisis. Antimicrobial Resistance & Infection Control, 7, 1-11.
Alarcon, F. J. (2022). The migrant crisis and access to health care. Delaware Journal of Public Health, 8(4), 20.
Chang, C. D. (2019). Social determinants of health and health disparities among immigrants and their children. Current Problems in Pediatric and Adolescent Health Care, 49(1), 23-30.
Funk, C., & Lopez, M. H. (2022). Hispanic American’s experience with health care. Pew Research Center Newsletter.
Hacker, K., Anies, M., Folb, B. L., & Zallman, L. (2015). Barriers to health care for undocumented immigrants: A literature review. Risk Management and Healthcare Policy, 175-183.
Philbin, M. M., Flake, M., Hatzenbuehler, M. L., & Hirsch, J. S. (2018). State-level immigration and immigrant-focused policies as drivers of Latino health disparities in the United States. Social Science & Medicine, 199, 29-38.
Pillai, D., Artiga, S., Hamel, L., Schumacher, S., Kirzinger, A., Presiado, M., & Kearney, A. (2023). Health and health care experiences of immigrants: The 2023 KFF/LA times survey of immigrants. The Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-and-health-care-experiences-of-immigrants-the-2023-kff-la-times-survey-of-immigrants/
The Kaiser Family Foundation. (2023). Key facts on health coverage of immigrants. https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/
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