The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jennifer Fuld, MA, ABD and Tamar Bauer, JD. New York Forum for Child Health, The New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029-5293, 212-822-7390, jfuld@nyam.org
Disaster Relief Medicaid (DRM) was a temporary public health insurance program with a simple one-page application that provided health coverage for eligible NYC residents after September 11, 2001. Approximately 342,000 New Yorkers, including many immigrants, enrolled in DRM and gained temporary but immediate coverage at the Medicaid/Family Health Plus (FHP) income levels. Only one-third of all DRM enrollees applied to transition to Medicaid/FHP and many eligible Latino immigrants who had benefited from temporary coverage have reverted to uninsured status. In January 2003, focus groups were conducted at a community-based health center to identify reasons why eligible Latino immigrants enrolled in DRM but did not transition to Medicaid/FHP. Focus group participants received temporary DRM coverage during 2001/2002, but were uninsured at the time of the focus groups. Despite positive experiences with DRM, both during enrollment and receiving health care, participants were reluctant to apply for Medicaid/FHP. Many participants cited immigration-related concerns such as fears that applying would affect their sponsors, their own immigration status or members of their family. Also discussed were general enrollment barriers including extensive documentation requirements, concerns about the asset test requirement and overall mistrust of the system. The barriers to enrollment in Medicaid/FHP were temporarily removed during the DRM enrollment process but re-emerged during the transition to regular coverage. After DRM ended, many Latino immigrants returned to being uninsured self-pay clients despite being eligible for Medicaid/FHP. The findings suggest the importance of simplification of the application requirements as well as outreach and education to immigrants.
Learning Objectives:
Keywords: Health Care Access, Immigrants
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.