As we have seen over the past several months, communities are only as protected against the coronavirus as their most vulnerable members. In our region, some of our most at-risk populations are undocumented workers, who work jobs deemed essential, and their children.
These families are facing the risk of contracting COVID-19 with no access to health care. Undocumented workers receive no employee benefits, including health Insurance. Because they do not meet the citizenship requirements of the state Children’s Health Insurance Program, or CHIP, undocumented children are shut out of public health insurance options.
In Berks County, there are about 5,500 uninsured children, some of whom are a portion of the 24,000 undocumented and uninsured children statewide.
As a pediatrician, I’m always hoping that lawmakers will see the connection between the fact that kids get sick, and if they are undocumented they are less likely to get care, including testing. With COVID-19, the stakes are higher, and lawmakers must confront the fact that undocumented children not having access to care puts their families and us all at risk.
I am most concerned about access to care for preschool-age children who are undocumented in particular. With schools and most child-care providers closed, parents aren’t connected to as many resources as they are when their children are in school and can get assistance from school nurses, counselors and other staff.
Most children who are infected by COVID-19 remain mercifully asymptomatic. But we must assume that even without symptoms children can transmit the coronavirus to family members and others.
People across southeastern Pennsylvania are coping with extreme anxiety, but imagine how it feels to be one of these parents, many of whom work in retail and other jobs deemed essential. The pressure to protect and provide for your family during a global pandemic is significant, but the toxic stress of having no health insurance for your children is entirely unnecessary and can be easily avoided.
An article in the Journal of the American Medical Association highlights another major problem with neglecting the uninsured: unnecessary hospital visits.
Without regular access to health care, children end up in emergency rooms for health crises that could have easily been remedied or detected through regular checkups. These visits amount to extraordinary costs for hospitals, significantly more than what it would have cost if they were covered through CHIP.
The article "Immigrant Health, Value-Based Care, and Emergency Medicaid Reform" explains how lack of health coverage "creates an environment favoring catastrophic and hospital-based care over ambulatory and primary care."
Catastrophic care is as expensive and wasteful as it sounds and flies in the face of bipartisan efforts to bring about value-based care, a particular focus of U.S. Health and Human Services Secretary Alex Azar.
Being uninsured severely impedes children’s ability to get health care – and the COVID-19 crisis has put the significance of having access to care and coverage into sharp focus. Pennsylvania legislators can amend state law and qualify all children. Six other states already cover all kids, including California, Illinois, Massachusetts, New York, Oregon, Washington and the District of Columbia. Pennsylvania must be next.
Organizations such as the Berks County Medical Society, Greater Reading Immigration Project and Hospital Association of Pennsylvania are supporters of covering all kids because it’s not only the right thing to do but the smart thing to do.
Pennsylvania lawmakers on both sides of the aisle support expanding children’s health insurance, including Berks County’s own Sen. Judy Schwank.
In the long term, the best hopes for our nation’s recovery from the pandemic rests on finding a vaccine and effective treatments for the Illness. But we must act to shore up the gaps in our public health strategies that leave us all needlessly vulnerable, let alone bring significant harm to families that slip through the cracks.
Dr. Karen Wang is a pediatrician at the Berks Community Health Center and school physician for the Reading School District
via The Reporter
July 13, 2020 at 10:31PM