As Block, Bustamante, de la Sierra and Cardoso (2014) point out, there are more than 12 million Mexican immigrants in the U.S. who have no realistic access to affordable care, as nearly half of them are uninsured. Indeed, access to quality care is next to impossible for all groups with a low-socioeconomic background (Sherrill, Crew, Mayo et al., 2005). The Affordable Care Act (ACA) was meant to provide greater access to care for low income populations; however, it “does not address lack of insurance for some immigrants, and the excluded groups are a large proportion of the Mexican–American community” (Block et al., 2014, p. 179). Block et al. (2014) suggest that the solution to this problem should be an innovative new form of health insurance coverage, such as bi-national health insurance—but they note that their research indicates such a concept is unlikely to find traction among an overwhelming majority of Americans, and neither would such a solution solve the problems inherent in the ACA itself regarding eligibility of specific immigrant populations for health care. Marshall, Urrutia-Rojas, Mas and Coggin (2005) present a similar problem for undocumented Hispanic immigrants (i.e., illegal immigrants in the U.S.) who have no insurance coverage and virtually no access to affordable care. Their study found that undocumented Hispanic women “were less likely to report having health insurance and a regular health care provider, and reported lower education and income” (p. 916). The proposed solution of Marshall et al. (2005) was to suggest “providing immigrant women with health services such as health fairs, affordable health insurance programs, community health services, and increased opportunities for participation in federal and state programs” (p. 916)—though this too raises the question of who will pay for these services and where the funds will come from. Should taxpayers shoulder the cost for undocumented immigrants’ health care services? This question is divisive and polarizing for people across the political spectrum, particularly for individuals who feel that universal health care is a step towards socialism—and they see countries like Venezuela on the verge of collapse and believe that is what would happen to the U.S. should it begin adopting socialistic practices. Marshall et al. (2005), like Block et al. (2014) offer up a solution, therefore, that is unlikely to gain traction in the U.S. as the issue of health care and who should...
However, as Brown, Wilson and Angel (2015) show, “health insurance coverage under PPACA excludes undocumented immigrants” (p. 990), which means that 3.7% of the population and 5.2% of the workforce are still not going to have the access to quality care they need (Brown et al., 2015). PPACA is, in short, another solution that is not really a solution, and falls in line with the proposals of Block et al. (2014) and Marshall et al. (2005). The solution proposed by Sherrill et al. (2005)—that the Accessible and Culturally Competent Health Care Project (ACCHCP), which is “designed to offer culturally appropriate, sensitive, accessible, affordable and compassionate care in a mobile clinic setting” (p. 356) presents the only real, viable alternative. The ACCHCP is unique in that it brings “nurse practitioners, health educators, bilingual interpreters, medical residents” and university students and professors together to help the underserved population of Hispanic immigrants in the rural southeast (Sherrill et al., 2005, p. 356). The ACCHCP works in the sense that the immigrants who used the mobile facility clinic stated that without this access to care “their only option for health care would be the emergency room” (Sherrill et al., 2005, p. 366). The program also works because it relies on a combination of volunteers, student learning, educational leadership, political leadership, and funding—all of which goes to support the population most in need. This is the type of solution that can help immigrant Hispanics to obtain the access to care that they currently lack—and it is a viable solution because it taps into the resources of American generosity and innovation in the sense that it relies upon funding set aside specifically for this purpose and is supported by educators, students and health care professionals who want to learn the tools of the trade and make a positive impact on the community.References
Block, M. A. G., Bustamante, A. V., de la Sierra, L. A., & Cardoso, A. M. (2014).
Redressing the limitations of the Affordable Care Act for Mexican immigrants through bi-national health insurance: a willingness to pay study in Los Angeles. Journal of Immigrant and Minority Health, 16(2), 179-188.
Brown, H. S., Wilson, K. J., & Angel, J. L. (2015). Mexican immigrant health: health
insurance coverage implications. Journal of Health Care for the Poor and Underserved, 26(3), 990-1004.
Marshall, K. J., Urrutia-Rojas, X., Mas, F. S., & Coggin, C. (2005). Health status and
access to health care of documented and undocumented immigrant Latino women. Health Care for Women International, 26(10), 916-936.
Ramos, I. N., Appana, S. N., Brock, G., Kalbfleisch, T., He, Q., & Ramos, K. S. (2015).
Health Status, Perceptions and Needs of Hispanics in Rural Shelbyville, Kentucky. Journal of Immigrant and Minority Health, 17(1), 148-155.
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