State’s ‘Deferred Action’ Immigrants Less Likely To Use Health Care

Latino young adults who qualify for the Deferred Action for Childhood Arrivals program in California are less likely to use medical services than young adults born in the U.S., according to a recent study, Payers & Providers reports. About 300,000 Latino young adults in California are eligible for DACA (Shinkman, Payers & Providers, 4/3).

Background on DACA

In 2012, President Obama developed DACA, which grants undocumented children legal status and authorization to work in the United States for two-year periods.

To be eligible for the program, children must:

• Have arrived in the U.S. before age 16;
• Be under age 31 as of June 2012; and
• Have continually lived in the U.S since 2007.

Although Medicaid expansion under the Affordable Care Act bars coverage for undocumented immigrants, a caveat in California allows those with "deferred action status" to gain coverage (California Healthline, 2/26).

Report Details

The study was conducted by researchers from the:

• Philip R. Lee Institute for Health Policy Studies at UC-San Francisco;
• UC-Berkeley Center for Labor Research and Education; and
• UCLA Center for Health Policy Research.

Researchers examined data from the California Health Interview Surveys from 2007 and 2009.

In addition, researchers conducted focus groups with 61 DACA-eligible young adults and individually interviewed 28 other DACA-eligible young adults.

Report Findings

Overall, the report found that Latino immigrant youth were hesitant to use U.S. health care services.

Specifically, it found that of those who qualified for DACA:

• 37% did not have a usual source of health care, compared with 29% of U.S.-born youth;
• 33% had not visited a physician in the previous 12 months, compared with 21% of U.S.-born youth; and
• 21% said they were in poor health, compared with 11% of U.S.-born youth.

Despite their low use of health services, the report found that DACA-eligible youth had high rates of chronic mental health issues, including:

• Anxiety;
• Depression;
• Stress; and
• Trauma. 

Reasons for Low Use of Health Services

The report noted several reasons for the population's low use of U.S. health care services.

One reason was the high cost of medical services and the potential consequences of not being able to pay for such services.

For instance, one interviewee noted, "My worst fear is getting sick, not having enough money to pay for it, being sent to collections and then the government would find out about it. A lot of people I know fear collections."

The report also found that many DACA-eligible youth are misinformed about their health care options under "Deferred Action" status and have low health literacy. For example, some individuals have health coverage but are unaware of what services are covered.

Others hear misinformation "from some eligibility workers who perpetuate inaccuracies regarding program requirements," according to the report.

The report noted that such inaccuracies are often repeated because of:

• Deliberate discrimination toward undocumented immigrants; or
• Unintentional lack of training.

Recommendations

The report offered several recommendations to encourage DACA-eligible individuals to use health care services, including:

• Combining primary and behavioral health services;
• Developing campaigns to strengthen health care literacy;
• Improving health care access;
• Providing more cultural-specific care; and
• Strengthening the health care safety net (Payers & Providers, 4/3).