The Forgotten (Not So)Few
Six years ago the Affordable Care Act (ACA) was enacted by President Obama. This act has significantly increased the number of insured people in the United States by providing affordable insurance to those with an annual income is below 138 percent of the federal poverty level. The ACA also expands mental health care coverage to those with low income, a significant improvement because in the past mental health care was not considered a necessity but rather a bonus. From this information, one can easily argue that the ACA has had a positive impact on the US health care system, however there are many people that argue against that, but my question is: is the ACA enough or do we need more reform?
The ACA is very inclusive, its primary goal is to provide as many people with health insurance as possible, to get rid of the large uninsured population. However, as inclusive as the ACA tries to be there is a significant population it leaves out: undocumented immigrants. This post’s purpose is not to argue whether the undocumented population should be insured by a federal program but rather to point out the fact that undocumented immigrants are uninsured and the following consequences and whether these consequences should cause us to act. The following are those who apply for coverage through the health insurance marketplace: U.S citizens, U.S nationals, and lawfully present immigrants. This policy leaves out more than 11 million residents of the United States. Although undocumented immigrants do not fall under the ACA they do fall under the EMTALA. The EMTALA is “The Emergency Medical Treatment and Labor Act is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay” (American College of Emergency Physicians). Although EMTALA definition doesn’t explicitly say undocumented immigrants, they do fall under anyone so they can receive treatment at emergency departments (EDs).
The combination of these two policies has led to basically only one option for undocumented immigrants: if medical care is needed one has to go to the ED, whether or not if it is urgent. One of the primary reasons why EDs get to the point of overcrowding because people who have non-urgent issues come in because they do not have access to anywhere else. The highest concentration of undocumented immigrants is in Los Angeles and not coincidentally Los Angeles has the highest rates of ED crowding. California in general has a large population of undocumented immigrants and has acknowledge this in several ways. Hispanas Organized for Political Equality (HOPE) is an organization that helps undocumented immigrants find access to affordable health resources. Medi-Cal, the state form of Medicaid, will soon cover illegally immigrated children, which is a significant step forward but many are still concerned about the large adult population which is being left out. Another program that California is trying to get started is allowing illegal immigrants to buy healthcare coverage. The author of this bill, Ricardo Lara states “This proposal affirms our commitment to embrace and integrate our immigrant community, to lead where the federal government has failed and to acknowledge the hard work and sacrifice of a community that contributes billions of dollars to our GDP”.
No matter what side of the argument someone is on, whether it is on Lara’s side which encourages the integration of immigrants into our system or the exclusion of undocumented immigrants one must acknowledge there is a problem and this problem is affecting everyone’s legal or not legal, emergency health care.
