States in U.S. ‘Midsection’ Address Immigrant Care

Health care officials in several states across the "nation's midsection" -- which has experienced the largest growth in immigrant population over the past ten years -- are beginning to "pa[y] ... attention to" the health issues of those immigrants, USA Today reports. While California, Florida, Illinois, New York, New Jersey and Texas have the highest number of legal and undocumented immigrants, states in the middle of the country, from coast to coast, have the fastest growing immigrant populations, according to the latest Census. Jeffrey Passel of the Urban Institute said, "These places are not used to dealing with immigration. Their health care systems may not be set up to deal with these populations." Rick Wade of the American Hospital Association said, "[S]ome of our members who were not dealing with [immigration] are now having to deal with it." He said that "figuring out ways to unclog emergency rooms" and translating Spanish to English are among the "many challenges" faced by hospitals. Providing care to immigrants, whether legal or undocumented, can be difficult for states, USA Today reports. For example, welfare reform laws instituted in 1996 restrict immigrants' access to Medicaid services, and at that time, some immigrants were asked to repay Medicaid benefits or "risk [losing] their residency status." Between 1994 and 1997, immigrants' use of public benefits dropped more than 30%. Undocumented immigrants often are reluctant to access health care services out of fear that a health worker "could feel compelled to report" them or that accessing free care could hurt their attempts to gain legal status. Clarissa Martinez De Castro, director of state and local public policy for the National Council of La Raza, a Latino advocacy group, said, "As an undocumented immigrant, you are extremely hesitant to receive services and help. You just want to work, support your family and keep a low profile" (Davis, USA Today, 9/6).