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Infectious diseases, as we learned these past few years, do not check your passport before sending you to the hospital. The coronavirus pandemic made clear that the need for medical care is fully independent of borders, nationality, or immigration paperwork. We all fall sick the same way, no matter where we were born, and we all must rush to the doctor with the same level of urgency when our health takes a turn for the worse.
In Connecticut, however, our health policies do look at our migratory status and passport when we seek medical care. Insurance coverage access is contingent on our place of birth and what kind of paperwork we can provide. As a result, tens of thousands of Connecticut residents are not eligible for health insurance coverage.
These policies have severe consequences. For those that cannot sign up for health insurance coverage due to their immigration status, it means living with the constant fear of anxiety that any illness, pain, or injury can quickly turn into a mountain of unpaid bills. More immediately, there is also ample research showing that the high out-of-pocket costs for those uninsured often leads to skipping routine care, including for otherwise manageable chronicle conditions, with potentially much worse health impacts down the line. Not going to the doctor today for fear of a pricey bill is common, and we know the results.
The cost of having people without insurance, however, goes beyond lack of coverage. Hospitals have a mandate to treat every single person that comes through their doors, regardless of their insurance or migratory status. If the patient cannot cover the bill because they do not have insurance, that “uncompensated care” ends up being paid by the state of Connecticut and the federal government. It is not a small sum: more than $800M a year in Connecticut alone, a figure made worse for all the postponed care mentioned above.
Finally, it should be obvious by now that our health is far from a private matter, only impacting each of us as individuals. The pandemic made clear that if someone in our neighborhood, our church, or our office is sick and cannot afford to go to the doctor, the impact goes beyond them to everyone in the community. Contagious diseases spread. We all share the cost of caring for the sick. We cannot restrict health and healthcare for arbitrary reasons; health is a community matter; we share the risk, and we all pay for it eventually.
Connecticut lawmakers, to their credit, know this is an issue, and have taken steps to address it. The trouble is, those steps have been fairly tentative and slow moving, and there is a lot more work that needs to be done.
Two years ago, the legislature expanded eligibility for HUSKY, Connecticut’s health insurance program for low-income families, to include undocumented children. Kids, after all, are in our state to no fault of their own. They should not be singled out due to bureaucratic reasons, so they should be insured. For some incomprehensible reason, however, lawmakers decided to pair this laudable decision with a strict age cut off – children older than eight were not covered. There is no discernible difference between a seven- and a nine-year-old on their way to the hospital, except regarding HUSKY eligibility.
The General Assembly revised the bill last year, raising the age cutoff to twelve, and allowing HUSKY-insured children to stay in the program until they turn nineteen. A good move for everyone, unless you happened to be an undocumented thirteen-year-old, of course.
There is an obvious solution, which is just opening HUSKY to everyone, without immigration or nationality restrictions. Immigrants pay their taxes (we pay our taxes) like everyone else. Leaving them uninsured makes little sense, both for the direct impact of those that lack coverage, and the money we end up spending to pick up the pieces anyway.
A bill under consideration at the Capitol (with a public hearing on Valentine’s Day) would close this gap, at least for children and young adults. H.B. 6616 would eliminate immigration status as an eligibility requirement for HUSKY participants under twenty-six, ensuring that the place of birth no longer carries any weight on the health of our kids. It’s essential that this session, at the very least, this bill passes without amendments lowering the age restriction.
There is one last point, however, that goes beyond any cost-benefit analysis of the bill, which will have a very modest price tag in any case. This is not just about public health, or uncompensated care, or insurance premiums. It is a matter of plain decency. We are in this together; we live together, we take care of each other, and we should care for each other’s health no matter what. It is wrong and immoral that a fourteen-year-old kid might be turned away from a doctor’s office because he was born on the wrong side of the border. We should fix that today because healthcare is a human right.