Organizations, healthcare providers advocate to expand Medicaid eligibility to undocumented immigrants
Community organizations, immigrant rights groups and healthcare providers across Connecticut have united to advocate for expansion of HUSKY eligibility –– a move that could grant all state residents, regardless of immigration status, access to health coverage.
On March 11, Connecticut’s Human Services Committee held a 12-hour hearing to discuss S.B. 956 — a bill that would make health care coverage available to everyone who qualifies for HUSKY, Connecticut’s Medicaid health program for low-income residents, regardless of immigration status.
At present, undocumented immigrants in Connecticut who otherwise meet the criteria for HUSKY are not covered by the program. In the past, fear of deportation and the need to pay expensive out-of-pocket fees to receive medical assistance have deterred those who need hospital care from getting it, aggravating conditions that could have otherwise been prevented. This situation often transforms traumatic accidents into chronic health problems, seeds exorbitant hospital bills and intensifies mental health struggles within the undocumented immigrant community, Matt Meizlish ’11 MED ’21 GRD ’21 said.
“This is a classist and oppressive system because, in this country, our health is just a business and not a priority,” Ubaldo Garcia, an undocumented resident of New Haven, wrote in the testimony he submitted for the March 11 hearing. “This is why we demand better public policies in healthcare, so that healthcare is available to all regardless of their status or how much money they have in their pockets — it [should] be available to them because they are human.”
If legislators vote to pass it, S.B. 956 would grant undocumented immigrants access to the same health coverage to which any other qualifying state resident is currently entitled.
At the March 11 hearing, over 150 testimonies were delivered by members of the immigrant community, health care providers and political figures.
Looney, who represents New Haven, is one of the co-sponsors of the S.B. 956 and testified in support of it at the hearing. New Haven Mayor Justin Elicker and Fair Haven Community Health Center CEO Suzanne Lagarde also delivered testimonies.
The human toll of HUSKY ineligibility
Ubaldo Garcia was run over by a drunk driver a year and a half ago. The accident mutilated his right leg and left him with serious kidney problems. But the state provided him with no financial support to get the medical attention he needed. He testified that he was only able to afford emergency medical care because of the insurance payment provided by the drunk driver.
Ubaldo Garcia will need medical care for the rest of his life. But because of his status as an undocumented immigrant, he has no assurance of state support to help him navigate this costly and difficult predicament.
“There was not even a single dollar to help me pay the bills or go through rehabilitation, and the health care system did not care that I lacked insurance and did not care to cover a prosthesis [so that I would] be able to have a minimally normal life,” Ubaldo Garcia wrote in his testimony. “Today, I cannot work or support myself. A prosthesis costs more than $40,000.”
In his testimony, Ubaldo Garcia explained that he can barely afford his gas bills right now, let alone a proper prosthesis that would allow him to resume his life as it was before the accident.
Rebeca Vergara Greeno MED ’22, director of the HAVEN Free Clinic, set up an online fundraiser to collect donations to help him pay for his prosthesis.
Laura Garcia, a resident of Norwalk, also suffered ineffable loss. Her son Matías passed away in her womb in the 39th week of her pregnancy — a death, she wrote in her testimony, that happened because her concerns went unheard.
“I believe that if I had had insurance I could have chosen any doctor and they could have saved my son’s life,” she wrote.
Even after telling her physicians that she had been gaining a lot of weight, seen her nails turn purple and spent most of her days vomiting, Laura Garcia said they dismissed her symptoms as minor and did not give her gestational diabetes the proper amount of attention.
Although she wanted to switch doctors and go to a different clinic, she was unable to do so because she was not eligible for HUSKY and did not have health insurance — the clinic where she was receiving treatment was the only one that would care for her due to her undocumented status.
“This was very difficult for me and I still have not recovered, because my son would be with me if they had listened,” Laura Garcia wrote. “The loss of my son is what hurts me the most, because I would have preferred to die myself and for my son to be alive.”
Nicolas Rodriguez’s family, which resides in Hamden, also testified that the current health care system wronged them. Rodriguez wrote that his wife was denied necessary surgery three times because of her lack of insurance and undocumented status. His despair over his wife’s pain caused him to pay for medical insurance for her and their kids, but not knowing how he would be able to afford the medical bills, he has developed anxiety and insomnia, according to his testimony.
Similarly, Guadalupe Garcia, an undocumented resident of New Haven, was laid off because of the pandemic and found herself uninsured in the middle of a global health crisis. She testified that the prescriptions for the glasses she currently wears are so outdated that they have been giving her migraines. She wrote that she is also unable to afford her eye drops — a special kind because she has eczema — now that she is no longer paid. Arthritis from the years she spent cleaning hotel rooms and dental problems are additional health concerns that health insurance would allow her to address, according to her testimony.
“I barely have any teeth, and the teeth that I have are in pain,” Guadalupe Garcia said.
A ‘patchy system’
Meizlish, an MD/PhD student at Yale, has had many patients who are undocumented immigrants. In his primary care experience, he has witnessed how systemic injustices often culminate in debilitating long-term conditions and life-altering mental health struggles.
Meizlish is a part of the HUSKY 4 Immigrants campaign, an effort spearheaded by immigrant rights groups to push for S.B. 956. His role in the campaign has involved harnessing support from health care providers who could use their medical perspective to advocate for the importance of S.B. 956.
“As health care providers, the best version of our activism is supporting those narratives and telling complementary stories from the other side of this health care picture,” Meizlish said. “We need to be using that position and using that voice to support what are very, very valid and important asks from the community.”
In the absence of state-sponsored health coverage, undocumented immigrants have to resort to a “patchy system” — one that offers no security, no guarantees and no support for people to seek long-term care when it is needed, Meizlish said.
According to Meizlish, the system also comes at a high cost for the government, which has to pay for that complicated treatment when a patient’s conditions become dire.
“When you let diabetes, for example, progress to a point where it requires amputations, and it causes cardiovascular disease, and heart attacks and chronic kidney disease that requires dialysis and a myriad of other complications, it is a major fiscal burden that ultimately the government does bear,” Meizlish said. “From a community health and from an economic perspective, it makes a lot more sense to do preventative medicine and to actually provide convenient access to health care as early as possible.”
Meizlish said that the human rights concern for these communities should be compelling enough on their own for legislators to support the bill, but that even those who are fiscally conservative should see the economic appeal of expanding this coverage.
Continuity of care is also a big issue for undocumented immigrants who cannot meet with a health care provider frequently, Julia Rosenberg, a pediatrician and postdoctoral fellow at Yale, told the News.
According to Rosenberg, if Connecticut were to pass S.B. 956, it would join Washington, D.C., and six other states in ensuring that undocumented children have access to health care.
“I care for many children in the state, but I really worry about the ones that I don’t see,” Rosenberg said. “We know that children who have access to continuous health insurance are healthier children and become healthier children. Children with continuous health insurance miss less school, they are able to have more successful careers and healthier lives as adults with fewer chronic conditions.”
Meizlish said that for undocumented immigrants to have equitable access to health insurance, it will take continued grassroots support from the immigrant community, local organizations and health care providers. But he believes that the support that senators, representatives and legislators have shown so far, for the bill and otherwise, are positive signs that the current reality could improve.
“Excluding undocumented immigrants from HUSKY is intentional, it’s explicit and it can be changed,” he said.
The role of grassroots activism
S.B. 956 is the product of years of work by the HUSKY 4 Immigrants Campaign, a coalition of state immigrant activist groups backed by health care providers. In addition to gathering testimony, the coalition also organized a rally in support of S.B. 956, planned to take place on Saturday in New Britain.
Guided by CT Students for a Dream, a youth-led organization that advocates for the rights of undocumented students and their families, the coalition includes Semilla Collective New Haven, Planned Parenthood Votes! Connecticut, Connecticut Citizen Action Group and Connecticut Working Families.
Carlos Moreno, state director of CT Working Families, told the News that immigrant activists in Connecticut are a “vibrant community,” and that the expansion of the HUSKY benefits that they are fighting for is a “top-tier issue.”
Guaranteeing HUSKY coverage for undocumented immigrants is also a personal mission for those within the coalition. Even before S.B. 956 was written, the cause behind the bill was close to the hearts of the members of CT Students for a Dream — many of whom are undocumented immigrants themselves.
Yenimar Cortes, New Haven organizer for CT Students for a Dream, told the News that growing up in New Haven, neither she or her parents had access to health care due to their family’s undocumented status.
“We know the struggles of not having health care and having to resort to home remedies or just suffer through the pain and not seek medical attention because we’re scared of the costs and also scared of deportation,” Cortes said.
Cortes, who first became involved with CT Students for a Dream in 2016 when she was a senior in high school, estimates that the group’s HUSKY expansion efforts began in 2018.
She said that in the fall of last year, CT Students for a Dream organized letter-writing campaigns to legislators and Gov. Ned Lamont that pushed for HUSKY expansion. In early September, the organization held a public demonstration outside the governor’s mansion.
“Health care … it’s a basic human right that we don’t have because of our status,” Cortes said.
The pandemic’s impact, the bill’s implications
The inability to access health care coverage has become even more of a life-threatening barrier for undocumented immigrants during the COVID-19 pandemic: According to health care nonprofit Families USA, it is estimated that 1 out of 3 COVID-19 deaths and approximately 40 percent of infections are linked to a lack of health insurance.
But Connecticut’s response to ensure that all state residents, regardless of immigration status, would have access to COVID-19 testing and treatment through emergency Medicaid funding provides a window of opportunity to further expand access to health care moving forward, Meizlish said.
“For COVID-19, it makes a lot more sense to prevent disease … rather than allowing it to progress to the point where someone needs intensive care,” Meizlish said. “But that logic is exactly the same logic that can be applied to every other medical condition … and it shows that if we want to do this, we can do it, it’s just a question of having the political will.”
Both Cortes and Moreno emphasized that the passage of S.B. 956 would have a large impact on New Haven, as it is an urban center with a concentrated population of undocumented immigrants.
“Undocumented immigrants contribute to our communities in countless ways and, despite myths to the contrary, contribute to local, state, and federal taxes that fund our government and programs such as Medicaid,” Elicker wrote in his testimony to the Human Services Committee. “Reducing access to healthcare for people who need it, particularly as we are in the middle of a pandemic that has taken countless lives and disproportionately devastated Black and brown communities, is bad for everyone.”
If passed, S.B. 956 will take effect on July 1.
Sylvan Lebrun | firstname.lastname@example.org
Maria Fernanda Pacheco | email@example.com