By Matt Van de Graaf and Elizabeth Beverly
These bills would establish a program that ensures access to health insurance for all children who call Virginia home, regardless of immigration status. It is crucial that Virginia seize this opportunity to cover all kids and brighten the futures of our children and our commonwealth.
One of our patients, “Rosa,” is one of many children who faces barriers when accessing health care. She is a 5 year-old who comes to our student-run free clinic for her routine pediatric care. Seeing Rosa, and so many other patients like her, is one of our favorite experiences as medical students, but it is simultaneously frustrating that so many of these children cannot access health care with the same ease as their peers. Many of the children we see have undocumented immigration status and must come to our free clinic, because they are not eligible for insurance that would cover the health care costs at a pediatrician’s office.
Most children living in Virginia receive health insurance through one of many options. However, there is an important group that is often left out: children who were not born in the United States. Inequalities in health care access and utilization have only been amplified by the COVID-19 pandemic, with millions of children losing health insurance across the country. In total, 4.9 percent of child in Virginia, or nearly 100,000 children, are now uninsured.
Within Virginia, undocumented children are disproportionately affected, with nearly 50 percent of them lacking access to insurance. These children do not have equal access to insurance coverage due to restrictions that prevent them from participating in Medicaid, the Children’s Health Insurance Program and the Affordable Care Act marketplace. They are our neighbors and will undoubtedly contribute to the continued success of our communities. Yet, they are being excluded from our health care system.
With a higher uninsured rate, immigrant families are often forced to delay or go without needed care. In fact, the Kaiser Family Foundation reports that “uninsured children are more likely to lack a usual source of care, to delay care, or to have unmet medical needs than children with insurance.” Even for common childhood illnesses, these children may endure worse health outcomes and preventable hospitalizations. We worry about what this means for our patients. What would happen to Rosa when she requires urgent medical care? What if Rosa had an asthma attack? Would her family struggle to get the medical attention she needs? Not only does this inequitable health care access lead to poorer health outcomes for children, it also creates an increased financial burden to the entire healthcare system.
Currently, 10 states and Washington, D.C. use or plan on using state- or district-only funds to provide health coverage to income-eligible children regardless of immigration status. New York has been doing so since 1990, and, as of 2019, 97.6 percent of the state’s children now have insurance coverage. In 2021, Virginia took an important step forward by passing legislation requiring the Virginia secretary of health and human resources to convene a workgroup to research and recommend strategies to finance health care services for children with undocumented immigration status. While the workgroup was a constructive step forward, it will only be meaningful if it leads to successful legislation that ensures healthcare access for these children.
When thinking about issues related to child health, a quote by Nelson Mandela comes to mind: “There can be no keener revelation of a society’s soul than the way in which it treats its children.” Our community and our country are built upon the foundation that accepting and nurturing those around us makes us stronger.
Children, like Rosa, are simultaneously the most vulnerable among us and yet also determine the strength of our future as a society. We have the opportunity to uplift every child by creating a state that ensures healthcare for all children. In doing so, we nurture the ideas, talents, and cultures of every Virginian and look to a future that will be brighter for every individual and community in our commonwealth. Let’s raise our voices and use our presence to advocate for what’s right; let’s urge our representatives (you can find yours here) to pass this legislation that supports healthcare coverage and access for every child in Virginia. That’s the Virginia we want to call home.
Matt Van de Graaf is a lifelong Virginia resident and a fourth-year medical student at Eastern Virginia Medical School. He plans to pursue residency training in pediatrics after graduating in May. Elizabeth Beverly was born and raised in Virginia and is a third-year medical student at Eastern Virginia Medical School with an interest in pediatrics. She is the current co-director of Clínica Esperanza, a student-run free clinic dedicated to providing free health care to the uninsured Spanish-speaking population of Hampton Roads.
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