As immigration reform is hotly debated in Congress this summer, I am focusing this post on what foundations are funding related to the health of immigrants.

A bit of background

“When Congress passed President Obama’s health care overhaul [in 2010], a critical compromise provision was that immigrants living in the United States illegally would not be allowed access to publicly subsidized health insurance,” reporter Jennifer Medina reminds us in an informative June 21 article in the New York Times. “Granting any kind of access to health care for immigrants is becoming a focal point” in the June Congressional immigration debate, “as many Republicans have said they would refuse to support change if it included providing care” for the undocumented.

In California, though, which has more immigrants than any other state, some groups are “trying to cobble together ways to provide preventive care for such immigrants,” Medina reports. In counties with many immigrants, such as Los Angeles, officials are saying “that not including immigrants in [some sort of preventive] coverage, regardless of their legal status, will only cost local government more in the long run.”

Medina also quotes Daniel Zingale, a senior vice president with the California Endowment (who has worked for both Republican Gov. Arnold Schwarzenegger and Democrat Gov. Gray Davis). Zingale says in the article, “It doesn’t take much to figure out that [the undocumented] will be driving our economy in the decades to come, so it’s in our interest to keep them healthy.” Medina characterizes the endowment as “a health care foundation leading the charge” to convince the state of California “to pay for comprehensive care for all immigrants.”

Yes, federal law mandates that emergency departments treat anyone, “regardless of legal status, insurance or ability to pay,” Medina notes. But it has been drilled into my head here at the journal where I work (and likely into your head, too) that such high-level care is expensive care that could be avoided if people got care before they became seriously ill.

Recent conference:

The Eighth Summer Institute on Migration and Global Health was held in the Bay Area of California in June. The California Endowment and the California HealthCare Foundation were among the sponsors of this joint effort. The University of California, Berkeley, School of Public Health’s Health Initiative of the Americas; the UC [University of California] Global Health Institute; and the Migration and Health Research Center joined together to convene the institute. Among the numerous people presenting was Richard Figueroa of the California Endowment, who spoke on “US Healthcare Reform and the Impact on Immigrants.” See his PowerPoint slides here, including helpful bulleted lists of the coverage that different types of immigrants are eligible for—for example, undocumented people cannot buy insurance through an exchange, “even with their own money.” (Figueroa also has worked for California governors Schwarzenegger and Davis.)

Recently awarded grants:

The California Wellness Foundation recently awarded a two-year, $200,000 grant to the Imperial County (California) Office of Education to support the Migrant Farmworker Dental Program. The funds will be used “to provide dental care services and education to farmworkers and their families.” The California Wellness Foundation is the only funder for this effort, according to Earl Lui, a program director at the foundation. Rural Imperial County is largely agricultural and near San Diego.

According to an April press release, the New York Community Trust awarded a $90,000 grant to the New York Immigration Coalition, which will be used for a statewide effort to “ensure that New York State’s health insurance exchange meets the needs of immigrants.” Other funders for the coalition’s health reform work include Health Care for All New York, which, according to the coalition’s deputy executive director Karen Kaminsky, re-granted money to the coalition from Community Catalyst’s Affordable Care Act implementation Fund.

Recent publications:

“Family Unity, Family Health: How Family-Focused Immigration Reform Will Mean Better Health for Children and Families,” released in June, gathers together a wide range of information “on the consequences of the threat of deportation and detention on the physical and mental health of children and families,” according to a press release. This health impact assessment looks at the results of current federal immigration policies on children of undocumented immigrants. Funded by the California Endowment and the Jacob and Valeria Langeloth Foundation, the report was prepared by Human Impact Partners, a public health research group. It reminds us of the well-known statistic that there are some 11 million undocumented people in the United States now. The report cites another statistic: “An estimated 4.5 million children who are US citizens by birth live in families where one or more of their parents are undocumented.”

Also, Karen Hacker of Harvard Medical School and the Institute for Community Health points out in the release: “If Immigrants avoid health care for communicable diseases because of fear of being deported, it becomes difficult to maintain the health of the larger community.”

This short report proposes “a series of recommendations that can begin to address the root causes of poor health status among families with undocumented members—namely, the fear, stress and potential trauma experienced by families whose unity may be threatened due to their legal status.” For example, the report recommended that the bill that was later passed by the US Senate  include “a path to permanent residence and eventual citizenship” for all illegal immigrants (except “those who pose a threat to national security”). This would eliminate the risk of being deported or detained and would foster the benefits to families’ health that are associated with “long-term stability,” the report explains.

“Undocumented Patients: Undocumented Immigrants and Access to Health Care,” released in March, is an executive summary on the findings of a Hastings Center project that ran from June 2011 to December 2012. Funded by the Domestic Human Rights Program of the Overbrook Foundation (a progressive family foundation located in New York City), the project was directed by Nancy Berlinger and Michael Gusmano of Hastings, a nonpartisan bioethics research institute. The project “explored ethical, legal, and policymaking challenges” that come up when undocumented people and their families in the United States need medical care. The summary contains several recommendations, from the project’s advisory group, “for integrating access to health care into immigration reform,” including the following: The secretary of Health and Human Services “should direct safety-net funding to states with large informal labor markets,” where undocumented and other poor immigrants “are likely to live and seek health care, [so as] to mitigate known uncompensated-care problems.”

Other outcomes of the Hastings project include an issue brief by Gusmano that is titled “Undocumented Immigrants in the United States: US Health Policy and Access to Care” and was released in October.

Related resource:

New York Immigration Coalition in conjunction with the Empire Justice Center released a report in February 2013, Maximizing Health Care Reform for New York’s Immigrants. Funded by the New York State Health Foundation, the report suggests “how New York State can address the health care needs of those left out of federal reform by making policy choices at the state level that expand access to health care coverage for immigrants, as well as by strengthening its safety net system,” says a press release. Among the statistics cited is that about 85 percent of immigrants in New York State are either naturalized citizens or legal residents.

Today’s news on immigration reform

“Boehner Sees Will to Act on Immigration in House,” Erica Werner, Associated Press, on WTOP news radio online, July 11. The US Senate has passed a bipartisan immigration reform bill; now the focus is on whether the House of Representatives will pass any legislation on this topic.