Opinion: Covering undocumented children is a healthcare win – The Connecticut Mirror

November 22, 2022

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Over the past 20 years, there have been extensive federal and state efforts to expand affordable health care coverage to millions of adults and children. In fact, the uninsured population in the United States has reached an historic low of 8.8%. But do these expansions cover everyone? What if you’re undocumented?
In June 2021, the Connecticut legislature passed a bill making all children under the age of eight who come from families earning up to 201% of the federal poverty level eligible for HUSKY coverage, regardless of immigration status. However, a similar proposal to expand coverage to undocumented children between the ages of eight and 19 failed in the 2022 legislative session. Instead, the legislature passed a reduced proposal to expand coverage to children under the age of 13, allowing children who enroll while they are eligible to maintain coverage until the age of 19. 
The overwhelming importance of health insurance coverage, particularly for children, was evidently overlooked by legislators. Children without health insurance coverage are more than twice as likely as insured children not to visit a physician over a 12-month period. Uninsured children are less likely than those with insurance to receive medical care for injuries. Children with medical conditions or developmental delays that go undetected or untreated can have poorer health outcomes. Gaps in health care coverage can also make it harder to manage chronic diseases such as diabetes and asthma. In turn, poorer health status is a contributing factor in school absenteeism and performance, impacting graduation rates, college attendance, and workforce readiness. 
Additionally, low-income uninsured children who are unable or ineligible to receive preventative or primary care can also become sicker and eventually require emergency room or hospital inpatient care. Overall, insured children typically  have better outcomes from hospitalizations than uninsured children. In fact, this study found that among children hospitalized in New York City for similar problems, the in-hospital death rate was almost one-and-a-half times higher for uninsured children than those who were insured.
Legislators cited their primary concern over passing the more expansive health care bill as a lack of information on the number of residents who would qualify for the program and what the cost would be to the state. But that ignores the true financial impact of healthcare coverage.
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A study conducted by RAND estimates that expanding HUSKY coverage to undocumented immigrants of all ages would cost approximately $83 million dollars, which is only about 3% of the state’s Medicaid budget. Additionally, the RAND study estimates that hospitals in the state could save approximately $50 to $59 million on uncompensated care if there was increased coverage among undocumented immigrants. Further, as health status correlates to educational outcomes and workforce readiness, there is a demonstrated increased output of productivity when a government invests in more accessible healthcare coverage.
While expanding insurance coverage will be an upfront cost to the state, it’s a small percentage of the state’s overall Medicaid budget, and would likely result in savings elsewhere. More importantly, it’s a cost we should be willing to pay to ensure all children receive health care coverage.
In the next legislative session, Connecticut lawmakers should pass the bill expanding eligibility for HUSKY coverage to all children between the ages of 12 and 19. Overall, health care coverage is crucial to childrens’ health outcomes and the potential financial benefits sufficiently address the budgetary concerns Connecticut’s politicians and constituents have expressed.
Undocumented children should not be penalized for the fact that they’re undocumented. 
Esme Ostrowitz-Levine is a senior at Trinity College double majoring in Public Policy & Law and Human Rights Studies.
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