On Thursday, November 20th, President Obama made public his historic Immigration Accountability Executive Action (IAEA). Immigrant rights groups across the city—and the nation—gathered to watch his prime-time address. Social media was buzzing with quotes from the speech and messages of solidarity. Celebratory rallies were held from Washington State to Washington Square Park. It was one of those collective TV moments, sitting before the screen and knowing that many people were doing the exact same thing.
While the IAEA offers much-needed, much-deserved deportation relief and authorization to work for undocumented immigrants, there are still many unanswered questions, namely the unforeseen impacts on public institutions and a still-marginalized immigrant community. Groups like New York Immigration Coalition and New York Legal Assistance Group are already doing what they can to prepare for possible repercussions, such as the budding opportunity for those who wish to take advantage of immigrants seeking legal advice. According to Manhattan District Attorney Cyrus R. Vance, Jr., “The threat of fraud against New York’s immigrant population is a real and present problem, and underscores the importance of those seeking assistance in immigration matters to hire qualified professionals, such as a lawyer or other accredited individuals.”
While legal assistance groups are navigating the intricacies of status applications, labor laws, and increased potential for immigrant fraud, we at AMPHS are preparing for the possibility of changing health needs and complications of healthcare access. It’s too soon to tell exactly how the President’s reforms will play out in the healthcare arena, but here are a few items we are looking at:
• Undocumented immigrants who are now authorized to work in the U.S. are able to pay in to and receive Medicare, Social Security, and other federal benefits.
• However, those granted deportation relief would not be eligible for student financial aid, food stamps, housing subsidies, or participation to the Affordable Care Act (ACA) exchange.
• This also means that employers now have what amounts to an incentive of $3,000 per employee to hire undocumented immigrants because they are not subject to coverage penalties under the ACA.
So what does this mean for immigrant health?
Hypothetically, it means more of the same. For decades, undocumented immigrants have been working in this country without legal authorization to do so and without adequate healthcare access. Now they can legally work, but healthcare access continues to be limited or nonexistent. U.S. healthcare providers are still adjusting to the new ACA status quo, but presumably that adjustment won’t include an influx of newly recognized immigrants.
On the other hand, it is probable that an immigrant community that has largely kept its health concerns in the shadows out of fear of exposure and deportation will now, justifiably, make its needs heard. Whether or not a person has access to healthcare, everyone has healthcare needs that must, in one way or another, be met.
Furthermore, the kind of work historically made available to undocumented immigrants is typically labor-intensive with more hazardous workplace conditions. Before the IAEA, immigrants who suffered injuries on the job may have been disinclined to report them, losing their livelihoods along with their health in the process; but now, there will be less risk associated with reporting injuries and seeking care. This raises further questions about workers’ compensation benefits and independent contractor abuses (again, we’ll leave those to the lawyers). But one thing seems evident: job-related health issues stand to contribute significantly to the immigrant health conversation and may lead to a greater demand for health services.
This is certainly new and exciting territory for our immigrant communities, and for public health. Even with all of these legal and policy mysteries, we at AMPHS couldn’t be more excited to be a part of this dialogue. However the IAEA reforms play out, we’ll be there to track and advise on any changes to healthcare access. We’ll continue to offer free health screenings to our community members without regard to legal status or coverage. We’ll do our best to diversify the impacts on Brooklyn’s community health system by providing an additional point of care. And we’ll continue to celebrate the acknowledgement and political advancement of the wonderful people we serve.
A door was opened on Thursday, November 20th. Let’s do all we can to make the most of that opening, and to see where else it can lead.