Immigration and the Border by Unknown

Author:Unknown
Language: eng
Format: epub
Publisher: University of Notre Dame Press
Published: 2016-08-15T00:00:00+00:00

Source: Families USA 2006.

In addition to barriers posed by access to information and extensive enrollment requirements, language continues to be one of the biggest obstacles to maintaining enrollment for Latino families. A study at the University of Pittsburgh examined over twelve thousand families and determined that difficulties with the English language may have cost five million eligible children their access to Medicaid benefits in 1992. Given that 75 percent of uninsured and Medicaid-eligible Latinos opted to conduct interviews in Spanish, researchers concluded that language difficulties are key to understanding the significantly higher rates of uninsured among Medicaid-eligible Latino children when compared to other racial and ethnic groups (Language Barrier May Keep Children Uninsured 2000).

Research has also shown that educational level greatly affects Latinos’ access to and utilization of health care services, since education affects occupational status, which in turn affects the probability of acquiring employment-based insurance. Higher levels of educational attainment are also associated with greater reception to learning about relevant health issues, as well as with increased ability to manage the complexities of any health care system. Research also suggests that higher levels of maternal education lead to greater rates of health care utilization among children (Byck 2000). For the sake of efficient policy implementation, policymakers must take into account clients’ differences in educational backgrounds even within the Medicaid- and SCHIP-eligible populations. When advertising the program, for example, program coordinators must clearly identify target groups and address the specific situation of each population.8

Yet perhaps the biggest factor contributing to low levels of enrollment in public health insurance programs among Latinos specifically is immigrant status. In addition to the linguistic and cultural barriers that many Latinos encounter, legal immigrants fear that receiving public assistance will threaten their immigrant status (GAO 1998; Maida 2001). This fear has its roots in the United States Immigration and Naturalization Service’s (INS) policy for “public charge,” which has had harsh effects upon both legal and illegal immigrants in large part due to its ambiguous definition. Prior to 1999, public charge policy essentially gave the INS grounds to deport or to deny entry to any immigrant who relied upon (or who was believed to potentially rely upon) public assistance as his or her main means of support (INS of the U.S. Department of Justice 1999). As Swingle (2000) demonstrated, one effect of public charge policy has been to deter immigrant women from seeking prenatal care and families from using immunization or nutrition programs for their children.

Recognizing the probability of negative health effects such as these, not only for immigrants, but for the larger population as well, in 1999 the INS sought to clearly define public charge as a description applicable only to those immigrants “who ha[ve] become (for deportation purposes) or who [are] likely to become (for admission or adjustment purposes) ‘primarily dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense’” (INS of the U.S. Department of Justice 1999).

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