Get with the Program

Jef­frey Toobin, in his arti­cle about the Flo­re­ses, a mixed-sta­tus fam­i­ly, describes a “com­pre­hen­sive break­down in pub­lic pol­i­cy” with regard to immi­gra­tion reform (“Amer­i­can Lim­bo,” July 27th). I write as a co-direc­tor of the Undoc­u­ment­ed Patients Project at the Hast­ings Cen­ter. Fam­i­lies like the Flo­re­ses have also been sys­tem­at­i­cal­ly exclud­ed from pub­lic ben­e­fits that pro­vide access to health care; owing to the par­ents’ inel­i­gi­bil­i­ty for Afford­able Care Act insur­ance sub­si­dies or for Med­ic­aid, the Flo­re­ses have lim­it­ed cov­er­age options, and are buy­ing insur­ance on the open mar­ket to help pay for a U.S. citizen’s can­cer treat­ment. Only a hand­ful of states have elect­ed to use state funds to cov­er undoc­u­ment­ed chil­dren. Only New York, Mass­a­chu­setts, and Cal­i­for­nia offer access to state-fund­ed Med­ic­aid for those enrolled in the Deferred Action for Child­hood Arrivals pro­gram. The undoc­u­ment­ed pop­u­la­tion is gen­er­al­ly young, but peo­ple do get sick, and undoc­u­ment­ed work­ers tend to be employed in jobs—food ser­vices, con­struc­tion, farm labor—that expose them to a height­ened risk of injury. Our patch­work of safe­ty-net pro­grams, fed­er­al and state exclu­sions, and expen­sive “emer­gency” pro­vi­sions makes nei­ther eco­nom­ic nor moral sense.

Nan­cy Berlinger
New York City

Nan­cy Berlinger is a research schol­ar at The Hast­ings Cen­ter and a co-direc­tor of the Undoc­u­ment­ed Patients project. 

This let­ter was orig­i­nal­ly pub­lished as a let­ter in The New York­er’s August 24, 2015 Issue. Please click here to access the orig­i­nal let­ter online.