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The Issues of Healthcare Coverage for Undocumented Immigrants in America

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More than 44.7 million immigrants lived in the United States in 2018. This number is expected to grow within the next generation. According to Hoefer, Rytina, and Baker, each year, an estimated 150,000 to 200,000 migrants from Mexico, El Salvador, Guatemala, and Honduras enter the United States in search of work opportunities, safety, and a chance at a better life. This growing number of immigrants is often unable to obtain a visa and enter this county illegally. Of the 8 million unauthorized immigrants currently residing in the U.S., nearly half are men between the ages of 18 and 34. According to the article, “Immigrant Eligibility for Health Care Programs in the United State, “unauthorized immigrants are not eligible for federal health insurance programs, and are only eligible for more discrete programs like emergency medical assistance under Medicaid, services in federally qualified health centers and certain public health programs”.

Immigration and healthcare coverage are both controversial and trending topics in today’s political climate. “Currently, addiction treatment for undocumented immigrants is so limited that a person with a severe substance use disorder may not be able to get treatment that would facilitate long-term sobriety”. As both of these subjects are debated in the political scope, the options available are limited. Little is known about SUD within immigrants. Little is known in this subject due to fear. Fear that undocumented individuals will be prosecuted as such when reveling their status upon admission to hospitals, clinics etc. These immigrants face long-term separation from their families, difficult working conditions, and loneliness thus develop depression and anxiety disorders. As a result, they turn to drugs and alcohol as maladaptive coping mechanisms. The Affordable Care Act, targets to increase availability of basic healthcare coverage. However, if you are in the U.S. without legal immigration status, you may not have access to these healthcare options. “Undocumented immigrants aren’t eligible to buy Marketplace health coverage, or for premium tax credits and other savings on Marketplace plans”.

Even though immigrants face disparities in obtaining healthcare, programs like Alcoholics Anonymous and Narcotics Anonymous are forms of receiving SUD treatment for those who suffer with mild to moderate SUD. However, programs like AA and NA are considered most effective when they’re used alongside addiction treatment. These programs only require attending meetings and the desire to stop using drugs or alcohol. These programs are free, and anonymity is a core component. This is essential when working with this population as there is no need to provide any documentation or proof or legal status.

Twelve-step programs are rooted in helping individuals realize and accept the need for change, accepting help from peers, surrendering to a higher power, and looking for amends. These programs also serve as a tool of connection in gaining relations with a community of people that are all dedicated to achieving one goal, obtaining and maintaining a healthier lifestyle. Although programs like AA and NA serve as vital resources for individual with mild to moderate SUD, they do not address the mental health component that many face. Another source for free SUD are local churches or charities that offer support to people who are undocumented. In most instances, they are able to provide some form of case management that connects one to community resources, sober housing, and support groups. Some groups may even provide immigration law services.

Although healthcare coverage is unavailable to undocumented immigrants, there is still hope. According to Serenity, there are few areas around the country where undocumented immigrants can receive healthcare coverage. For instance, Los Angeles offers My Health LA. “My Health LA is a free healthcare program for low-income residents that aren’t eligible for California’s state medical coverage”. Most of the individuals who use this form of healthcare are undocumented immigrants. This plan has many requirements such as being a resident to LA and have income of less than $1,397 per month, for single-member households or up to $6,861 for 12 member households. San Francisco has a similar plan called Healthy San Francisco.

Healthcare coverage is important as one is in need for SUD treatment. According to the article, Barriers to Drug Abuse Treatment for Latino Migrants: Treatment Providers’ Perspectives, inpatient and outpatient SUD treatment are covered through Medicare or Medicaid. Without any form of insurance, these forms of treatment range from inpatient hospitals stays to paying $1,400 for a three-month outpatient service. Outpatient services include counseling, pharmacological treatment, and patient education. Acute situations in which one is should seek treatment immediately include drug overdose, suicidal thoughts among others.

Besides a lack of documentation and healthcare coverage, migrants may face several other barriers to SUD treatment. Anyone who is struggling with a form of substance use disorder has barriers to overcome. Some of these barriers include stigma, healthcare, trying to hide the addiction from loved ones, unwillingness to admit there is a problem, concerns about privacy, economic cost, and the treat to job security. Some of these barriers are heightened for undocumented individuals. For example, job loss can be distressing as there is a limited amount of jobs that are assessable for this population. Also, as mentioned earlier, most immigrants are men, most of which need to provide for their families in other countries. Moreover, the language barrier can also hinder why undocumented individuals do not feel conferrable in seeking treatment or filling out the necessary documentation. Most inpatient facilities in the US are English-speaking which add to the barriers. The threat of being discovered and deported are also significant barriers to getting addiction treatment. Due to these barriers, undocumented individuals often go without treatment until they are court-mandated to a program (e.g., following a DUI conviction) or suffer injuries and other substance use-related health crises that require emergency medical services.

Regional studies of Latino migrant laborers have identified prevalence rates as high as 80% for regular binge drinking 39% for alcohol dependence and 25% for methamphetamine and/or cocaine use (Pagano, 2014). One study found that 66% of Latino migrant laborers’ emergency department (ED) visits were related to alcohol misuse which in the case of undocumented individuals is pressing as it can cause deportation.

Addiction is a disease that can affect multiple aspects of your life. If left untreated, it may start to affect ones’ health, relationships, finances, and legal status. The hopelessness to maintain addiction often leads people to illegal activities that lead to arrest. For a citizen, that could mean court-ordered therapy or jail-time. For an undocumented immigrant, it could mean deportation. Seeking help, even if it’s through limited options accessible to an undocumented immigrant, is superior than letting addiction rule your life. 

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