Undocumented children deserve health care in NJ and the sooner the better Opinion

By Heather Koball, Seth Hartig and Suma Setty

For children to thrive, they need and deserve quality healthcare. Regular doctor visits keep children on schedule for their vaccines, help spot developmental delays, and detect asthma and other chronic conditions. Unfortunately, children in families that lack health insurance too often don’t get that care.

It’s especially difficult for the families of undocumented immigrant children living in New Jersey to get care because they are ineligible for public health insurance through Medicaid and the Children’s Health Insurance Program (CHIP).

New Jersey is taking preliminary steps to make all children eligible for public health insurance, regardless of their immigration status, through the state’s Cover All Kids program. Govt. Phil Murphy’s proposed budget for the upcoming fiscal year would commit $11 million to expanding eligibility for the program. However, the coverage won’t begin until January 2023.

Undocumented immigrants are part of New Jersey’s strength in diversity. Undocumented residents of New Jersey are overwhelmingly employed, working hard and contributing close to $600 million in state and local taxes and over $1 billion in federal taxes that fund public healthcare and insurance programs.

But, because of their immigration status, they aren’t allowed to buy coverage from the Affordable Care Act’s health care marketplace. So, today, the only way undocumented immigrants can get health insurance in New Jersey is if their employer provides it. Many, though, work in low-wage jobs that don’t offer health coverage.

Across the country, 42% of undocumented immigrants don’t have health insurance, compared to only 8% of US citizens. In New Jersey, about 800,000 (33%) US citizen children receive their health insurance through Medicaid or CHIP, while undocumented children are currently barred from receiving this insurance.

Six states currently provide state-funded healthcare coverage to all income-eligible children regardless of immigration status. An analysis using the National Center for Children in Poverty’s recently launched Family Resource Simulator shows how extending eligibility for Medicaid/CHIP to undocumented immigrant children benefits them as well as their families’ health and financial well-being.

The simulator calculates a family’s net resources over a range of earning levels. Resources include earnings, tax credits, and public benefits, minus such basic family expenses as child care, food, medical costs, rent and taxes paid.

In New Jersey, undocumented immigrant children can’t receive assistance from numerous major public support programs, including the federal Supplemental Nutrition Assistance Program (formerly known as food stamps), Temporary Assistance for Needy Families cash assistance (often referred to as “welfare”) , housing vouchers, childcare subsidies or utility assistance.

This leaves their families substantially worse off than other families who struggle to make ends meet. For example, a two-parent/two-child family of US citizens in poverty is eligible for assistance that helps pay for food, housing, childcare, phone and utility bills, and health insurance. They also are eligible for the Earned Income Tax Credit and Child Tax Credit. None of this help brings a luxurious existence. It just helps families get by.

Based on our simulator’s analysis, expanding access to CHIP/Medicaid for undocumented children would reduce out-of-pocket medical expenses by $1,690 annually for a family living at the poverty line with two children, and up to $3,000 for a family above the poverty line .

Being able to enroll in Medicaid/CHIP would eliminate a huge barrier to healthcare for these children. It also would save the government money. Today, the healthcare many of these kids get is likely to come in hospital emergency rooms paid for at high rates by the state — in other words, taxpayers.

It makes better health and financial sense to provide preventive care on the front end, rather than limit care to emergency or charity care.

Today, many children who are our neighbors, friends, and relatives can’t get this essential care at a time when — thanks to the ongoing pandemic — even attending school poses a risk to their health. This is especially important for children under 5 who do not yet have the option of being protected with a COVID-19 vaccine.

Getting the healthcare that other kids get would enable their full participation in school and society, and, eventually, the workplace. These children deserve no less. Making these children eligible now for provisions established by the Cover All Kids legislation is the right thing to do.

Heather Koball is co-director National Center for Children in Poverty, (NCCP).

Seth Hartig is a senior research associate at NCCP.

Suma Setty is a senior policy analyst at the Center for Law and Social Policy (CLASP).

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