Over the past 20 years, there have been extensive federal and state efforts to expand affordable health care for millions of adults and children. In fact, the uninsured population in the United States has reached historic levels down from 8.8%. But do these extensions cover everyone? What if you are 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 extend coverage to undocumented children between the ages of eight and 19 failed in the 2022 legislative session. Instead, the legislature passed a reduced offer to extend coverage to children under age 13, allowing children who enroll while eligible to keep coverage until age 19.
The enormous importance of health insurance, especially for children, has apparently been overlooked by lawmakers. Children without health insurance are more than twice as likely as insured children not to see a doctor in a 12-month period. Uninsured children are less likely than those with insurance to receive medical care for injuries. Children with illnesses or developmental delays that go undetected or untreated may have poorer health outcomes. Gaps in health care coverage can also make it difficult 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.
In addition, low-income, uninsured children who cannot or do not qualify for preventive or primary care may also get sick and end up needing emergency room or hospital care. In general, insured children tend to have better hospitalization outcomes than uninsured children. In fact, this teaching found that among children hospitalized in New York City for similar problems, in-hospital mortality was nearly one and a half times higher for uninsured children than for those who were insured.
Lawmakers indicated their main concern over the passage of the more expansive health care bill as a lack of information about the number of residents who would be eligible for the program and what the cost to the state would be. But that ignores the true financial impact of health coverage.
A a study conducted by RAND estimates that expanding HUSKY coverage to undocumented immigrants of all ages would cost approximately $83 million, which is only about 3% of the state’s Medicaid budget. In addition, the RAND study estimated that the state’s hospitals could save approximately $50 to $59 million for uncompensated care if there is increased coverage among undocumented immigrants. Also, because health status correlates with educational attainment and workforce readiness, there is a demonstrated increased productivity when the government invests in more affordable health care.
Although the expansion of insurance coverage will be an upfront cost to the state, it is a small percentage of the state’s total Medicaid budget and will likely result in savings elsewhere. More importantly, it’s a price we must be willing to pay to ensure that all children receive health coverage.
In the next legislative session, Connecticut lawmakers must pass a bill expanding eligibility for HUSKY coverage to all children between the ages of 12 and 19. Overall, health coverage is critical to children’s health outcomes, and the potential financial benefits are well worth the budget concerns Connecticut policymakers and voters have expressed.
Undocumented children should not be penalized for being undocumented.
Esme Ostrovitz-Levin is a senior at Trinity College majoring in Public Policy and Law and Human Rights Studies.