Michigan’s immigrant children left out of health care

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Capital News Service 

LANSING – Michigan is one of 16 states that have yet to provide health care to children who are lawful immigrants.

“There’s this assumption that all noncitizens drink from some kind of firehose of public resources, when, in fact, it’s just the opposite,” said Susan Reed, the managing attorney with the Michigan Immigrant Rights Center, a legal resource center for immigrants.

In Michigan that amounts to 3,000 to 4,000 children with a green card or visa, said Simon Marshall-Shah, policy analyst for the Michigan League for Public Policy. Such immigrants must wait five years before they can access Medicaid or the Children’s Health Insurance Program in states that fail to adopt a federal option to do so.

Federal law prohibits nonlegal immigrants from accessing public-benefit programs such as Medicaid. But those who come to the United States legally could immediately enroll in a health care program under the 2009 Immigrant Children’s Health Improvement Act, if Michigan adopts it.

“I would guess that the vast majority of the public would assume that a child with a green card is already eligible,” Reed said. 

Even when a child is lawfully residing in Michigan and meets the income requirements to be eligible for the Children’s Health Insurance Program, they do not have access to health care resources, Marshall-Shah said.

Lacking health care in Michigan does not prevent anybody from seeking out emergency services. Hospitals must treat anyone who walks in the door and who needs life-saving treatment. The hospital signs the patient up for Emergency Services Only Medicaid to be reimbursed for care, Reed said.

But emergency Medicaid is much more expensive for the state than the Medicaid and children’s health insurance allowed under the Children’s Health Improvement Act. And if Michigan adopts the Improvement Act, it would receive a “very substantial” federal match for the first five years that immigrant children are legally living here, Marshall-Shah said. 

“So we’ll be on the hook for a fraction of the cost,” he said.

The federal match covers 80% of the cost of health care services obtained as a result of a state adopting the act, which means the state is only responsible for one-fifth of the cost.

That is still too much for the state.

“Michigan has not been able to take up the ICHIA option,” said Bob Wheaton, a public information officer for the Department of Health and Human Services. “There are costs associated with any coverage expansion and funding has not been appropriated to do so.”

The Immigrant Rights Center has raised adopting this option with multiple administrations without results.

“The Whitmer administration has led on health, and so we really think it’s time to focus on this issue and get it done,” Reed said.

Legislative action is not needed to adopt the act. It could be done through administrative changes by the state.

Michigan can be proud that 97% of children have insurance, Marshall-Shah said. But to reach 100%, access needs to be expanded to immigrant children. 

“Adopting this option is a way to send a powerful message that Michigan is willing to take up immigrant-inclusive policies so that everybody who could be eligible for a program like Medicaid or CHIP is,” Marshall-Shah said.

The pandemic should make Michiganders even more aware that access to health care is a community concern, Reed said.

“When you have families who are not able to access primary care for their kids, that can affect every child in a class, that can affect the child’s whole community,” Reed said. “It can affect the parent’s ability to get to work and the employer’s ability to function. So, you know, our health really is interrelated,” she said.

And it costs the system more to treat illness later, that could be managed or prevented right now, Marshall-Shah said. 

Emergency Medicaid is also an unsustainable solution.

“Imagine trying to manage a child’s juvenile diabetes without a primary care provider and with only the emergency room,” Reed said.

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