Non-citizens are three times more likely to be uninsured than U.S. residents. With nearly 10 million legal immigrants living in the country, the high percentage of uninsured among them means a bigger target for Obamacare. During rollout last year, the Obama administration was extremely concerned about the health insurance status of this section, and implemented some methods to make sure that sufficient enrollments came through immigrants. As per the Affordable Care Act, legal immigrants are mandated to get health insurance under the Obamacare marketplaces or face tax penalties for non-compliance. Although enrollments have come through, the majority of immigrants have no idea of how their health insurance works, and how are they supposed to make use of it.
These legal immigrants have no clear concept of health insurance, and that is why they are facing trouble while understanding and using the America healthcare system. For instance, immigrants who visit doctors and are asked to pay a co-payment bill respond by refusing to pay the bill and stating that they have already paid their monthly insurance premium and that should cover all the associated bills. Some immigrants show their indignation by saying that it is a scam.
For authorities working to make enrollments easier for immigrants, the challenges are multiple. Other than translating the fine print of the health insurance law, these experts have to explain the concept of co-payments and deductibles to each family in order to help them understand the healthcare system. Due to a lack of a complex healthcare system in their native countries, immigrants are unable to grasp the workings in time, leading to confusion and outrage when they use their insurance. These problems are not limited to any single demographic, but persist across all immigrant population. For some people, their home country has always provided government-sponsored healthcare, and they are the most uninitiated on the concept of health insurance. Most don’t want to purchase health insurance as they assume that the government will take care of their medical expenses.
Other than the basic concept of using health insurance and paying for it, there is another major problem. Immigrants feel that they are paying hefty sums for their health insurance and yet, they have to wait too long to get attention from a doctor. Several immigrants feel that they get cheaper, quicker service in their home country, while the American system fleeces them while providing delayed doctor and hospital appointments. Experts say that since their country runs on a socioeconomic scale of issuing appointments, they feel lost when it comes to the American healthcare system.
Other than these typical health insurance challenges, the immigrant population with chronic diseases has some cultural stigmas to battle as well. For instance, in some cultures, women are not allowed to go for tests such as mammograms. They feel that if they were diagnosed with cancer, no one would marry their children as these cultures consider cancer to be hereditary. The same goes for several other chronic issues that are the source of stigma in certain cultures.
Collectively this lack of a clear concept of health insurance and medical care is impacting the enrollment of the immigrant population. Out of the 10 million legal immigrants, only a few million have enrolled, while the others are not convinced enough to get insurance even if it means tax penalties for them. To cater this population, the Obama administration has initiated some unique ventures through their regular community-based programs and community-specific exchange navigators who encourage and help immigrants enroll with the law. For instance, people who do not understand the working of the law are given special education sessions that explain the financials, application and usage of the health insurance. For culture-specific challenges, the administration has setup camps where people with chronic diseases are paired with survivors of the same disease from the same community for sharing knowledge and breaking the stigma and bias against these medical issues. Similarly, a veil of anonymity is maintained for females that take tests for chronic diseases like cancer, so that they do not suffer a cultural impact.
Even then, the cultural challenges compounded with lack of a basic concept of health insurance are proving to be a bit too much for the Obama administration. The participation of this population is crucial for the Obama government to make true on their promise of a fully insured America, and enrollments are not as impressive as they should be.