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Health and Nursing Issues Related

to Undocumented Immigration
Presented By:

Morgan Howe & Katie Morell

Undocumented Immigration
11.7

million unauthorized immigrants


in US
3 out of 5 undocumented immigrants
are uninsured
32% have no health insurance in 2015
No preventative care
Only seek treatment for emergent
care or through free clinics

Learning Objectives
After

viewing this presentation the


student will be able to recognize
health and nursing issues pertaining
to undocumented immigration.

The

student will be able to identify


policies pertaining to health care
coverage for undocumented
immigrants.

Assessment of Healthcare
Environment
Policies

and politics

1986 Emergency Medical Treatment and


Active Labor Act
1996 PRWORA, IIRIRA, and California
proposition 187
2010 ACA
Ethics

Patient fear of deportation and medical


repatriation
Nurses must be sensitive to their vulnerability
Nurses must separate personal feelings from
duties

Assessment of Health Care


Environment
Financial

Do not qualify for federal healthcare


EMTALA only covers stabilization
Actual cost of care for
undocumented immigrants is difficult
to calculate
Resource
Federally Qualified Health Centers
(FQHCs)
Safety-Net Hospitals
Humanitarian Organizations

Assessment of Healthcare
Environment
Nursing

Practice & Quality and Safety

Nurses have an ethical obligation to


be advocates for patients and their
ability to access healthcarethe
American Nurses Association will
reaffirm its position that all
individuals living in the U. S.,
including documented and
undocumented immigrants, have
access to healthcare (ANA, 2010).

Assessment of Healthcare
Environment
Assumptions:

Undocumented immigrants are the main


contributors of uncompensated care
All undocumented immigrants lack
health insurance
Undocumented immigrants spread
communicable diseases

Root Cause Analysis


Health Disparity:
Undocumented Immigration

Underuse of Services

Language
Confusion
Fear
Policies
Barriers
of
of
Deportation
Insurance

Lack

Inferences and Implications and


Consequences
Burden

placed at state level

Federally

Qualified Health Centers

Hospitals

may not be able to make up

the cost
States

may pass laws allowing


purchase of private insurance

Inferences and Implications and


Consequences
Postnatal

care of undocumented immigrant


offspring increase

No

funding may decrease health outcomes

Incidence

of infectious diseases will

increase
Poor

health and increase co-morbidities

Recommendations
Support

safety-net systems such as free clinics

Advocate

for healthcare reform to diminish the


health disparity of undocumented immigrants

Advocate

for immigration reform to increase


the likelihood of naturalization

Volunteer

Conclusion/Summary
3

out of 5 undocumented immigrants likely lack


insurance

Only

seek treatment in emergent situations

Utilize

FQHCs when available

Many

policies exist related to health care


coverage

States

have financial burden

Ethical

responsibility of nurses

References

American Nurses Association, (2010). 2010 House of Delegates: Resolution: Healthcare for
undocumented immigrants. The Kansas Nurse, 85, 6, pp. 22.

Centers for Immigration Studies, (2015). Illegal immigration the numbers. Retrieved from
http://cis.org

Centers for Medicare & Medicaid, (2015). Health care coverage for immigrants. Retrieved from:
https://www.healthcare.gov/immigrants/

Cornell University Law Center. (2014). Illegal immigration reform and immigration
responsibility act. Retrieved
fromhttps://www.law.cornell.edu/wex/illegal_immigration_reform_and_immigration_responsibil
ity_act

Coustasse, A., Lorden, A., Nemarugommula, V., Singh, K. (2009). Uncompensated care costs: A
pilot study using hospitals in a Texas county. HOSPITAL TOPICS: Research and Perspectives
on Health Care, 87, 2, 3-11.

Gusmano, M.K. (2012). Undocumented immigrants in the United States: U.S. health policy and
access to care. Retrieved from http://www.undocumentedpatients.org/issuebrief/health-policyand-access-to-care/

Irvine, D. (2009). How illegals could obtain health insurance. Retrieved from
http://www.aim.org/don-irvine-blog/how-illegals-could-obtain-health-insurance/

References

Pickert, K. (2014). Undocumented immigrants could get health insurance in California. Retrieved from
http://nation.time.com/2014/02/18/undocumented-immigrants-could-get-health-insurance-in-california/

Sanchez, G.R., Sanchez-Youngman, S., Murphy, A.A.R., Goodin, A.S., Santos, R., Valdez, R.B. (2011).
Expanding public support (or lack thereof) for extending health coverage to undocumented immigrants. Journal
of Health Care for the Poor and Underserved. 22:2. Retrieved from http://
0-muse.jhu.edu.libcat.ferris.edu/journals/journal_of_health_care_for_the_poor_and_underserved/v022/22.2.sanch
ez.html
Sommers, B. (2013). Stuck between health and immigration reform-Care for undocumented immigrants. The New
England Journal of Medicine, 369;7, 593-595. doi: 10.1056/NEJMp1306636

Southern Medical Association Newsroom. (2015). Illegal immigration and the threat of infectious disease.
Retrieved from http://sma.org/illegal-immigration-and-the-threat-of-infectious-disease/

Stimpson, J., Fernando, W., Eschbach, K. (2010). Trends in healthcare spending for immigrants in the United
States. Health Affairs, 29, 3, 544-550

Young, M. & Lehmann, L. (2014). Undocumented injustice? Medical repatriation and the ends of health care. The
New England Journal of Medicine, 370;7, 669-673. doi:10.1056/NEJMhle1311198

Zong, J., Batalova, J. (2015). Frequent.ly requested statistics on immigrants and immigration in the United States.
The online journal of the migrant policy institute. Retrieved from http://
www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states#TOP

Zamosky, L. (2014). Healthcare options for undocumented immigrants. LA Times. Retrieved from
http://www.latimes.com/business/la-fi-healthcare-watch-20140420-story.html#page=1