Changing Employer Sanctions in Immigration Policy to Accommodate Undocumented Immigrants

Healthcare and Undocumented Immigrants
Student’s Name
Institutional Affiliation
Healthcare and Undocumented Immigrants
Immigration and healthcare are among the most debated topics in the US presently, considering their impacts on various policies. The number of immigrants keeps increasing globally, and the US is not exempted. Presently, the US federal law instills limitations on the privileges that immigrants, especially the undocumented ones, can enjoy while living within the nation’s boundaries. Part of the limitations to undocumented immigrants is access to healthcare. The current law does not allow undocumented immigrants to have access to healthcare services or insurance coverages as other US citizens do. That has triggered a debate considering the health implications associated with poor access to healthcare services. As immigration remains a federal issue while healthcare is a state policy issue, there are disagreements on what policy changes to initiate to achieve the best outcomes for undocumented immigrants. This paper suggests immigration policy change at the federal level and insightful changes in the state healthcare policies reach the demands of universal healthcare for every person. Changing the employer sanctions in the immigration policy should steer a congruent healthcare reform to accommodate undocumented immigrants without further burden, as evident in a few states such as California.
Background
The issue of undocumented immigrants should be accorded more attention bearing the current state of immigration in the US. There were 10.4 million undocumented immigrants in the US as of 2019. That number represents 3% of the US population (Ro & Jennifer, 2021). The issue of illegal immigration into the US is one that the nation has grappled with for a long time. In 2011, 40 million people, or 13% of the US population, were born outside the US borders. The unauthorized immigrants, those who entered the nation illegally or those with expired visas, continue to have their numbers escalate despite the new policies aimed at closing the US borders. Latin America contributes to the largest number of immigrants to the US. Approximately 35% of all immigrants come from Latin America. Half of all the immigrants from Latin America are from Mexico. The US also has immigrants from Asia (28%), 12% from Europe, 4% from Africa, and 2% from North America, and 1% from Oceania (Ro & Jennifer, 2021). Immigrants come to the US from all over the world.
The number of undocumented immigrants is spread throughout the US states with notable variations in some regions. Half of the unauthorized immigrants are concentrated in New York, Florida, Texas, and California. The numbers also vary by gender, with women accounting for 47% of undocumented immigrants (Ro & Jennifer, 2021). The number of undocumented children is 10% due to the 4th Amendment granting US citizenship to children born in America. As such, most children who live in unauthorized families are American citizens. Even by virtue of being American citizens, children from families headed by unauthorized immigrants are more likely to lack healthcare insurance. It is worth remarking that most unauthorized immigrants live in the US for long durations. Eighteen percent of the immigrants have lived in the US since the 1980s, while the 1990s and 2000s constitute 41% and 42%, respectively (Ro & Jennifer, 2021). Most of the unauthorized immigrants in the US have lived long enough to warrant some of the privileges of US citizens.
Most undocumented immigrants live in poverty and showcase low rates of insurance coverage. The majority of undocumented immigrants in states such as California contribute to the state’s economic activities (Hacker et al., 2015). Such individuals work in physically demanding service, agriculture and construction jobs. Even with the heightened risks of injuries and diseases in their job designations, undocumented immigrants still do not access healthcare insurance as well as other US citizens. Also worth noting is the understanding that undocumented immigrants cannot access basic healthcare services such as preventive care. Such limitations mean that the individuals manifest a higher prevalence of illnesses that can be managed through preventive care. Also worth remarking is the understanding that undocumented immigrants barely seek emergency services, thereby risking their health further, especially with the kinds of jobs that they must partake in to provide for themselves and their families.
Federal Government Policies
The federal government has played a significant role in the state of healthcare access to undocumented immigrants presently. The 4th Amendment remains an important document on understanding the scope of access to healthcare services by unauthorized immigrants (Hacker et al., 2015). The 4th Amendment grants US citizenship to children who are born in the US. That provision allows such children the privileges enjoyed by other Americans, including access to healthcare insurance. However, with their parents undocumented, the chances are high that such children cannot evoke the privileges of the 4th Amendment. Ultimately, they stand at a risk of contracting illnesses and not securing the best healthcare services.
The Patient Protection and Affordable Care Act (ACA) has fuelled the plight of undocumented immigrants in healthcare. Undocumented immigrants are excluded from the benefits provided under the ACA (Hacker et al., 2015). Such individuals are also faced with federal cut payments to disproportionate share hospitals, which makes it more challenging for safety-net hospitals to offer care services to such individuals. Presently, the challenge lies with the states that can revitalize access to undocumented immigrants through the expansion of Medicaid. However, states have also been reluctant to implement the policies to enhance access to care by immigrants, with only 27 states having allowed access to expanded Medicaid.
The US has had a history of steering universal care despite the immigration challenges that it faces. In 1986, the federal government approved the Emergency Medical Treatment and Labor Act (EMTALA) that required healthcare facilities and care providers to offer services to active emergency and labor care regardless of immigration or insurance status of the individuals (Martinez et al., 2015). EMTALA eased individuals’ access to care services, albeit in emergencies. In addition to EMTALA, emergency Medicaid was approved to cover patients with medical emergencies and those in active labor. Emergency Medicaid remains the only federal insurance policy that serves the needs of undocumented immigrants. It is worth remarking that emergency Medicaid can only be used in emergencies and cannot be used to offer services after patients are stabilized.
There has also been the expansion of other federal laws to accommodate some healthcare needs of unauthorized immigrants. Presently, the federal provisions that undocumented immigrants can access include prenatal care and care for children funded by maternal and child health block grants as well as the supplemental food programs that majorly target infants, children, and women. In 2009, the Children’s Health Insurance Program (CHIP) was expanded under the Reauthorization Act (Martinez et al., 2015). The expansion of CHIP led to increased federal government funding to CHIP in states. Some of the services that CHIP would cover under the new provisions include hospital care and services, access to medical specialists, vaccinations and prescription drugs, treatments for medically necessary mental health and dental services, and early and periodic screening. While such services remain available to a subset of undocumented immigrants, the resources barely cover the needs of sick adults and non-pregnant adults.
There are also Federally Qualified Health Centers (FQHCs) that have played a significant role in the provision of healthcare services to undocumented immigrants. FQHCs are community health centers that are eligible for federal grant funds to support care to the uninsured. FQHCs offer their services to individuals despite their immigration status. There are approximately 1200 health centers throughout the US that offer healthcare services under the umbrella of FQHCs (Hacker et al., 2015). Some of the services offered at such facilities include pharmacy services on a sliding scale basis, mental health, dental care, and primary care. Such services remain vital to the health of undocumented immigrants. Additionally, there are free community and low-cost clinics all over the nation that relies on private donations and volunteers to offer healthcare services to individuals who cannot afford them. The services, however, are not comprehensive and do not cover complex medical needs that need proper insurance coverage.
Employer sanctions remain among the biggest challenge towards advancing healthcare insurance to undocumented immigrants. The employer sanctions are enshrined in the 1986 Immigration Reform and Control Act (IRCA) (Hacker et al., 2015). The act prohibits employers from recruiting, hiring, or referring for free aliens known to work within the US. Unauthorized immigrants are categorized under unauthorized workers who should not be hired in the US labor market. Without proper employment policies, unauthorized immigrants can barely access insurance coverage. The IRCA provisions partly extend to ACA that further limits unauthorized immigrants from private insurance or the market places. All such provisi...