Affordable Care Act doesn’t translate well

Insurance remains out of reach for some immigrants

As a 12-year-old, Requel Roman moved to Chicago from Mexico. As one of five children, she said there wasn’t always enough money to go to private doctors. Roman remembered a time when one of her brothers had a high fever. The family didn’t have health insurance so Roman knew her parents were faced with a costly doctor bill.

“At that time, they had to make the choice,” Roman said. “You know, paying the rent instead of taking my brother to the doctor.”

Her dad insisted on paying the rent, she said, so the family didn’t lose its apartment. Instead, her mother tried home remedies to bring her brother’s fever down. But now, she said, because of the Affordable Care Act, it will be easier for some immigrants dealing with the same issues her family encountered to purchase insurance.

Jose Galarza, the billing manager of the Infant Welfare Society of Chicago, said that immigrant families without health insurance often weigh their options just as Roman’s parents did — deciding whether to put food on the table or take a sick child to the doctor.

Many of immigrants wait until they are very ill go to the doctor, said Galarza. This leads to a need for access to discounted medication as well because patients wait until infection sets in, he said.

In addition, Robin McGinnis, CEO of the Infant Wellness Society in Logan Square, said that of the immigrants the society serves, many are considered working poor or undocumented. Although undocumented immigrants do not qualify for health insurance under the Affordable Care Act, she said many of the working poor would have trouble paying the hefty premiums as well.

“We’re trying to educate them to take the higher premium plan even though it will cost them more monthly,” McGinnis said. “It will be less costly if there is a problem.”

Insurance is difficult for anyone to understand and the added language barrier only makes the process more challenging, she said. Get Covered Illinois, the “marketplace” for purchasing insurance, allows users to choose from a variety of languages, but the printable insurance application is only available in English.

When the Affordable Care Act takes effect in 2014, the working poor might opt for the $95 fine for not signing up for health insurance. Galarza said even those who qualify for a reduced rate could still end up paying about 8 percent of their already low annual income in fees for insurance.

“It’s cheaper for them to not get the health insurance and not pay the premiums,” he said.

Lavia Quiñones, the director of the immigrant-family resource program at the Illinois Coalition for Immigrant and Refugee Rights, said another issue is the number of mixed-status families — some undocumented, some with visas and some who are citizens. This only adds to the confusion of who is eligible for insurance, she said.

Undocumented immigrants will be most at risk after the Affordable Care Act is enacted, Galarza said. He foresees the government cutting funding for Federally Qualified Health Centers, which receive more reimbursement from Medicare or Medicaid and provide healthcare in underserved areas. Clinics will be forced to turn undocumented immigrants away, he said, or find a way to provide care for those who aren’t eligible for healthcare.

“That’s a population that nobody’s thinking about at this point,” Galarza said.

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