Everybody in. Nobody out.
As medical students, we see patients from all walks of life. At my rural rotation in Belle Glade, Florida, I saw my fair share of undocumented workers and their families who worked with sugar cane. These are patients with the same hopes, fears and health problems as the rest of the country.
Actually, a lot of the time, their health outcomes can be worse because of lack of access to preventive care. It was almost common to have patients come in with blood pressures in the 200/100s. We would then need to send these cases of uncontrolled hypertension to the small hospital next door to receive care which would ultimately be more costly than if they were able to get preventive health care in the first place.
In 2012, the immigrant population was at roughly 40.8 million, 11.5 million of which were unauthorized. With the recent instability in Central America, this figure is expected to rise significantly. Not taking into account the economic impact of allowing this population to receive health care would be a mistake. It is estimated that the price of subsidizing undocumented workers’ health care is $10.7 billion per year, according to the Federation for American Immigration Reform (FAIR). In its current form, the Affordable Care Act does not allow undocumented workers to participate in the health insurance exchanges, but they are able to apply for Medicaid in cases of emergencies, prenatal care or long-term care. Also, children of undocumented immigrants can have access to health insurance exchanges and Medicaid if they are legal permanent residents, which is not an easy status to attain.
There are many reasons to allow undocumented workers health care, not the least of which is the moral obligation as future physicians to do so. We currently have an aging population, so it would make sense to have a younger immigrant population able to contribute to this system. The ability to access preventive care services is integral to keeping a population healthy and leads to improved public health outcomes.
As much as we want the government out of our exam rooms—and believe me we do—some of our representatives in Congress should really take the time and see what the narrative and experience of this vulnerable population is before passing judgment. And for future physicians, I suggest going on a rural rotation if you are able and work with underserved populations such as these, because we are our patients’ best advocates.
Dr. Britani Kessler is AMSA’s national president and a recent graduate of Nova Southeastern University College of Osteopathic Medicine.