Affordable Care Act - Focus on Immigrants - Research Paper Example

Affordable Care Act: A focus on Immigrants Introduction The healthcare sector in America is one of the major areas of growth and development on which the government has taken an ardent and exceptional interest. Records show that America is one of the leading countries in the world where healthcare is at its best, and has been evidenced by the very low infant mortality rates and the many programs that address the needs of the elderly, the disabled and the low income earners (Gorin 3). The boost in health, lately, has been due to the Affordable Care Act, commonly known as Obamacare. The ACA has been imperative in providing Americans with better health security by introducing suitable insurance reforms in the country (Ortega 187). In the past decades, many Americans remained uninsured due to the expensive nature of insurance, and largely due to the poor and unfair code of conduct of many insurance companies. For example, the insurance companies could withdraw or rescind a person’s coverage just because they are suffering from heart diseases, diabetes or other long term chronic illnesses (Fernandez-Kelly and Portes 54). The companies also discriminated against the children, denying a majority of them the coverage they were warranted. Young unemployed adults also had a rough time as the companies sidelined them and denied them insurance. However, the Affordable Care Act has made things better and more affordable for people (Dolgin and Dieterich 46). Why the Affordable Care Act? It is a chance to fix the trust that was earlier broken as the terms of the ACA demand better services and programs from the insurance companies. Not only has it reduced the costs of insurance charged by the companies but has also reduced the much discrimination that the companies practiced earlier. Important to note is that ACA is a combination of two legislations, the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (signed in 2010) (Le-May 24). With this combination, the ACA serves to increase and expand the Medicaid coverage to the many low income earners in America, and greatly improving the Children’s’ Health Insurance Program. Therefore, in a summarized way, the ACA legislation seeks to expand Medicaid coverage to all Americans, give a chance for people to enjoy a variety and choose from diverse services, promote quality healthcare for all people and lastly, ensure that insurance companies remain accountable to their customers, conducting their businesses in a transparent and fair manner (Le-May 40; Bustamante, 320). However, the number of people who are uninsured still remains hefty. Some of the reasons cited in a research conducted showed that a big percentage cited the high insurance costs as a major reason for being uninsured (Gorin 4). The various reasons are as shown in the diagram below. Records show that there is a huge number of people in America who have remained uninsured, even with the introduction of the Affordable Care Act. Statistics on the immigrants in America By 2012, there were about 40 million people living in America who were uninsured (Edwards). Of this uninsured people, the bigger percentage comprises the immigrants. The immigrants in America are drawn from all parts of the world and as they traverse the different world’s places, they are determined to get to the world of opportunities, as America is commonly referred. However, some of them end up disappointed and frustrated and end up taking jobs that pay a very meager salary, placing them way below the federal poverty limit. Records show that the highest numbers of immigrants are from Mexico, and they make up the greatest number of the total uninsured people in America (Nwesu, Batalova and Gregory). The diagram below shows the different compositions of immigrants in America and their origins. The statistics below have been drawn from a 2013 study carried out and was intended on adding up the total number of immigrants into America. About 16 % of the American population comprises of immigrants, a total of about 43 million people (Edwards). However, the number of immigrants streaming into America is expected to increase with the high rate of growth and development being experienced here, coupled with the need for employment for the working age bracket youth. If the table below is anything to go by, the trend has been an increasing one and hence, it is only natural for one to make an assumption that the trend shall be the same for the coming years. If the diagram above is anything to base an argument on, then one can argue that the number of uninsured people is likely to increase, with the biggest percentage of the uninsured being the immigrants. The Mexicans make up about 12.75 million of the US immigrants, and a research conducted in 2013 showed that 47% of these were uninsured (KFF). Among the many reasons given for being uninsured, majority cited the heavy costs of insurance (private insurance) and the many children in their households who need to be insured. This means that, most of the uninsured were youths aged above 26 years and the parents (Nwosu, Batalova and Gregory). It is also important to note that an approximate 20% of the uninsured comprises of the non-elderly (Le-May 44). The Affordable Care Act and the discrimination on immigrants Unfortunately, as sound and fitting as the Affordable Care Act is, the interests of the immigrants appear to have been left out in it. As earlier mentioned, the immigrants remain the greatest percentage of the people who are uninsured today. The reasons, arguably, are the high insurance and medical costs, as compared to the low income bracket where a majority of them (80%) of them lie (Healthcare.gov). The main argument which was forwarded as to why the immigrants should be excluded was that they are a contributing factor to the high costs of living and expenses bestowed on the government, and they further contribute to an increase and overcrowding in the emergency department (Bustamante 321). Another argument raised was that including the immigrants will further promote and increase the number and rate of illegal immigrants flocking in America (Ortega 187). As a result of this decision, many immigrants have remained uninsured and have had their children insured too, thanks to the Affordable Care Act. In the following segment, a detailed analysis and description on who among the immigrants is covered (or is not covered) and qualifies (or does not qualify) for enrolment in the Affordable Care Act is provided. To begin with, any legal permanent resident who has been living in America for a period exceeding five years and a naturalized inhabitant qualifies for enrolment (Berlinger 16). A naturalized inhabitant simply means a person who was not born in America (is not a citizen by birth) but has lived in the country for more than five years and has acquired an American citizenship. This is the case with some of the immigrants as they were not born in America, but after some time, they have been able to change their status to that of legal immigrant as they have acquired the American citizenship. Such a person qualifies for enrolment in the ACA and other healthcare programs in the USA. In addition, such a person is also eligible for Medicaid, even though it is dependent on ones level of income. Medicaid is a healthcare program that is available for adults who do not exceed 65 years of age, and their monthly income is in an excess of $138% of the federal poverty limit (Le-May 54). This therefore means that this naturalized citizen, just like any other American citizen, has the right and qualifies for enrolment. Another person who qualifies for enrolment is a legal and permanent resident who has lived in the U. S, even if it is for less than five years (Van and Gray 347). Immigrants who earn below 400% of the federal poverty level have the advantage and benefit of qualifying for healthcare coverage that is subsidized (Healthcare.gov). The federal poverty level stands at 133% (Edwards). This has greatly helped in reducing the number of uninsured people in the United States of America since there is a large group of immigrants who fall under this category. The fact that they qualify for subsidized medical care means that a greater percentage if immigrants with earnings in the stipulated category are able to insure themselves (parents), their young children and also the young adults who are still dependent on them. Another category of people who qualify is one that is based on humanitarian grounds. This includes people like refugees from different parts of the world. Presently, there are many countries that have become war-zones, with massive issues of civil wars. The countries that are members of the United Nations have a responsibility coming to the aid of these countries. In America, refugees also have an advantage of qualifying for enrolment on the ACA and other healthcare programs. Still based on the humanitarian grounds, some asylees and different immigrants qualify for the enrolment. These special categories of people qualify for enrolment irrespective of how long they have lived in the U.S. as a result, the number of uninsured people (refugees, asylees and immigrants under special cases) has drastically reduced and consequently, the emergency department overcrowding has massively reduced (Kaiser Family Foundation). In addition, there are immigrants who are undocumented but they qualify for coverage. Examples include undocumented immigrants who have social security numbers or identity cards that have been issued to them by an overseas consulate (Fernandez-Kelly and Portes 94). This particular category can apply for private insurance as they have no option of applying for the state based health cover which is more subsidized and affordable. An example of a state where this is very common is California (Bustamante 323; Van and Gray 348). The governing council allows undocumented immigrants to apply for Medicaid. However, the services provided from this particular coverage extend mostly too prenatal and emergency services. As much as this is not the best coverage that a person might prefer, some immigrants who are undocumented have cited it as being a great source of help and relief for them as they are sure that they have some form of insurance in case of emergency needs. Since California is one of the states with the highest number of undocumented and uninsured immigrants, this move has greatly addressed their health and insurance needs, providing some form of security for them. If other states followed suit, then it is highly probable that the number of uninsured immigrants would reduce. However, other undocumented immigrants remain ineligible for healthcare coverage in America. This forms a big percentage of the uninsured, especially those in the age bracket between 30-60 years of age (Healthcare.gov). This category comprises of immigrants who are in the working poor and lower working class who would rather have their children insured. In addition, most of these undocumented immigrants have low education and hence, they have been unable to secure well paying jobs and hence, their children end up having low education, and the cycle reoccurs again. When this happens, the number of uninsured immigrants continues to steadily increase, an aspect which has become a great concern to the congress, and to the United Sates government at large. However, even though the healthcare issues and needs for immigrants have been taken care of in a very shallow manner, with much discrimination against them, the health needs and interests of the children have been taken care of. As earlier mentioned, the Affordable Care Act aims to greatly ensure that all children are able to access healthcare, and this has greatly aided in reducing the rate of infant mortality. As a result, immigrants who are undocumented but have children who are U.S citizens have an advantage (Gorin 4). The parents themselves do not qualify in the healthcare insurance exchange. However, the children to the undocumented immigrants who have YU.S citizenship and are legal permanent residents are qualified for the health insurance coverage. They also qualify for Medicaid, irrespective of their immigrant background, or the income level of their families. This provision has been beneficial to the immigrants as their children have been able to remain insured. For example, the Latino population makes up an approximate 30% of the total legal population in America (Berlinger 17). While about 60% of these remain uninsured, about 90% of the children born to the Latino legal migrants have their children insured (KFF). In a research carried out in 2012, parents expressed their relief for having their children insured even if they (parents) do not qualify for the insurance coverage (Le-May 101). This is because most of them cannot afford to subscribe for insurance coverage from private companies as they are way above their ability to afford. In addition, DACA (the Deferred Action for Childhood Arrivals) has been of much help to young immigrants (Dolgin and Dieterich 60). This legislation which was enacted in 2012 gives room for young children to be temporarily employed for 2 years, a period through which they are free from deportation (Healthcare.gov). This act has greatly helped young people to not only become self reliant but to also cater for their medical coverage. Not only has this been a relief for parents but also for youths who migrate to America alone, in the absence of a parents company. In addition, records from a research carried out in 2012 showed that an approximate 70% of youths in America have a constant need to visit the doctor (Fernandez-kelly and Portes 132). However, only about 20% of these visited the doctor in the previous year since the charges were way too high. DACA, therefore, has greatly helped the young immigrants in America. The makers of the Affordable Care Act policy made and passed rules and regulations that deny undocumented immigrants the right to access healthcare. These precincts have seen to it that all undocumented immigrants and those who do not qualify in the conditions stipulated above do not access Medicaid services and benefits, and have remained unable to procure health coverage through the healthcare exchange market place (Edwards). As affordable as it is, most of the undocumented immigrants have remained uninsured as they do not meet the conditions laid out by the Affordable Care Act policy makers. What does this mean? Many issues crop up from the restrictions placed on the immigrants. With the passage of time, more and more immigrants continue to enter America. However, as long as the restrictions remain, it means that the number of uninsured people continues to increase with every passing day. Today, the over 30 million immigrants present in the country seek their medical services from the healthcare centers financed by the government, or from private doctors (Bustamante 319). This means that with the increase in number of immigrants, the number of healthcare service providing centers have to be increased to effectively cater for the many undocumented and uninsured immigrants, and the other American native citizens who still cannot afford to purchase their coverage from the marketplace. This also means that the funds allocated today by the congress to cater and finance the healthcare centers will have to be increased. With the introduction of the Affordable Care Act, the federal expected that more people will enroll for the coverage but unfortunately, the number still remains high. This means that the funding for the healthcare will have to be increased to cater for the increasing number of uninsured immigrants (Gorin 5). It also means that the undocumented immigrants remain discriminated based mostly on their financial status. America should be an equal society where all individuals have a right to fair treatment and should be able to access medical care and other services. This therefore means that the immigrants will continuously feel sidelined and neglected. Conclusion A significant percentage of the American population is made up of immigrants. Of the total American population, the greater number of the uninsured is made up of the immigrants. In addition, as seen above, the trend of immigrants streaming into the U.S remains on an inclining slope and hence, the number is expected to increase. This means that the government should have measures and issues to address this case. The government should pass a legislation that addresses the health needs of the immigrants since they also contribute to the growth and development of the country. The Affordable Care Act has been helpful and has played a very significant role in ensuring that a majority of American residents have been insured, but the fact that the healthcare needs of immigrants has been left out is an issue that should be addressed. Works cited Berlinger, Nancy. The ethics of advocacy for undocumented patients. Hastings Center Report. 43(1), 14-17. 2013. Print. Bustamante, Van. Integrating immigrants into the U.S health system. American Medical Association. 14(4), 318-323. 2012. Print. Dolgin, Janet, and Dieterich, Katherine. Social and legal debate about the Affordable Care Act. UMKC Law Review, 80(1), 45-90. 2011. Print. Edwards, James. Immigration and Obamacare. Center for Immigration Studies. 18th February 2013. Web. 17th May 2014. Fernandez-Kelly, Patricia, and Portes, Alejandro. Health care and immigration: Understanding the connections. London: Routledge. 2013. Print. Gorin, Stephen. Repealing and replacing the Affordable Care Act: Prospects and limitations. Health and Social Work. 36(1), 3-5. 2011. Print. Healthcare. Gov. Immigration status and the marketplace. Www.Healthcare.gov. March 2014. Web. 17th May 2014. Kaiser Family Foundation (KFF). Key facts about the uninsured population. The Kaiser Family Foundation, 26th September 2013. Web. 17th May 2014. Le-May, Michael. Transforming America: Perspectives on U.S migration. London: ABC-CLIO. 2012. Print. Nwesu, Chiamaka., Batalova, Jeanne., and Gregory Au-Clair. Frequently requested statistics on immigrants and immigration in the United States. Migration Policy Institute. 28th April 2014. Web. 17th May 2014. Ortega, Adrienne. And healthcare for all: Immigrants in the shadow of the promise of universal healthcare. Journal of Law and Medicine. 35(1), 185-204. 2009. Print. Van, Ginneken, and Gray Bradford. Coverage for undocumented migrants becomes more urgent. Annals of Internal Medicine, 158(5), 347-348. 2013. Print. Read More