CT helping dozens of undocumented immigrants with prenatal care
Access to the state’s Medicaid program continues to expand, although some advocates say more work is needed to ensure everyone who needs the health care is eligible.
The latest extension of the Connecticut’s Medicaid program, HUSKY, was approved by the legislature last year. Now, more than 200 pregnant, undocumented residents in Connecticut are getting their prenatal care completely covered.
As of April 1, pregnant undocumented individuals can apply for health coverage for prenatal care. With this, pregnant non-citizens in Connecticut can receive pregnancyrelated care without monthly payments and certain co-payments. Labor and delivery will also be automatically covered.
The expansion applies to residents whose income is under 264 percent of the federal poverty level, or about $35,877 for an individual, and who do not qualify for Medicaid due to their immigration status.
Some 219 people have already signed up as of May 5, according to Peter Hadler, director of the Department of Social Services’ Program Oversight and Grant Administration division. DSS expects about 1,400 people to sign up annually.
Department of Social Services Commissioner Deidre Gifford said delivery has always been covered under emergency Medicaid for an undocumented person, as well as certain life-threatening emergency visits, but prenatal care can be an invaluable facet to a child’s longterm health.
“Early prenatal care is associated with better birth outcomes,” said Gifford.
According to the National Institute of Child Health and Human Development, prenatal care can reduce the risk of complications in both the pregnancy and the infant.
“It’s in everybody’s interest,” Gifford said. “Not to mention being the right medical and humane thing to do.”
Once these children are born, they will be citizens and, if they remain in Connecticut, will be eligible for health coverage through HUSKY. This prenatal care “means they’re more likely to be healthy as young children and adults,” Gifford added.
As of April 1, postpartum coverage was also extended from 60 days to 12 months for HUSKY A and B members who are citizens or qualified non-citizens. Postpartum care for non-qualifying immigrants will start on April 1, 2023.
When an undocumented pregnant person in Connecticut enrolls in this program, it will not affect their application for citizenship. The Department of Social Services also does not report information to Immigration Services or the Department of Homeland Security.
“We protect their information like we do all of our clients,” Hadler said. “This is not information that’s shared beyond the agency for purposes of their enrollment and care.”
Gifford knows that some potential clients could be reluctant to sign up as they’re concerned about their data and privacy. That’s where providers who work with the undocumented population regularly have come in and helped effectively deliver the message that their clients will be safe enrolling.
“The department and your provider will never share your immigration status,” Gifford said. “So, you should feel comfortable coming forward.”
“It’s the best thing for you and it’s the best thing for your baby to get into prenatal care as soon as you can,” she said.
Mirka Dominguez-Salinas, program manager and case manager for the Services for Undocumented Neighbors Program at Integrated Refugee & Immigrant Services, said she has a handful of pregnant clients who she is talking to about the program. Ultimately, though, it’s the client’s decision to sign up.
Camila Bortolleto has seen the undocumented population express apprehension at programs in the past, including when the state started issuing driver’s licenses to undocumented immigrants, as well as when it allowed more undocumented immigrants to apply for in-state college tuition and seek financial aid.
Bortolleto is the co-director and co-founder of Connecticut Students for a Dream, an organization that advocates for policies that help immigrant youth, undocumented students and families.
“They’re scared that they’re going to get in trouble,” Bortolleto said. “It is a legitimate fear, but we don’t want people to be scared ... These kind of programs were created to help people get the access that they need.”
Last year, the legislature approved this prenatal expansion, as well as providing coverage for undocumented children up to 8 years old starting in January 2023 and covering postpartum care for undocumented residents starting in April 2023.
Though residents could apply as early as April 1 for prenatal care coverage, many who tried to sign up got denied at first due to internal errors. However, the Department of Social Services reviewed all denials and confirmed enrollment with individuals who qualified.
Hadler said he feels confident about the new expansions starting next year, and the department stands ready to provide services if the legislature decides to expand coverage.
Most recently, the legislature approved another expansion to provide health care for undocumented children up to 12 years old whose guardians meet the qualifying income limit. This goes into effect in January 2023 as well, according to the CT Mirror.
“As a physician and a parent, I think that this is a really positive step for Connecticut. It’s something we can be very proud of,” Gifford said. “Making primary care services and basic health care services available to all children in Connecticut, it makes a lot of sense for every resident of the state, not just for
those children and their families.”
People who work with the undocumented population, as well as have experience themselves being undocumented, agree that though this is a step in the right direction, it’s not enough.
“Prenatal care is just so important to care of the baby when you’re pregnant,” Dominguez-Salinas said. “Unfortunately, it doesn’t last past that period and so a lot of these women are still going to need care.” Bortolleto agreed.
“It’s kind of the bare minimum,” Bortolleto said.
The HUSKY for Immigrants Coalition was pushing for legislation that would expand HUSKY to undocumented minors 18 and under. However, this failed to make it out of the Human Services Committee despite more than 200 people testifying their support of the bill, according to the coalition.
“The goal that we have, which is a long-term goal, is to get HUSKY open to everyone who qualifies,” Bortolleto said, promising to return to the legislature next session to push for more expansions.
“We can’t just stop at young kids and pre-teens,” she continued. “To really have healthy families, we need everyone to be insured.” “The job isn’t done,” she added. Currently, undocumented residents could purchase health insurance through the marketplace, Bortolleto said. For many, though, this would eat up most of their living wages. Even when some try to sign up for insurance through their employer, they sometimes get denied because they don’t have a social security card.
Dominguez-Salinas said some of her family members who were undocumented never had access to basic physicals. She also recounted how some of her clients have been injured at work and continued to stay in pain because they feared the cost of a doctor’s appointment.
“It’s just far too common and it really shouldn’t be,” she said.
Later, those same family members and clients may need to go to the hospital for a major surgery.
Undocumented residents usually have to get medical help from the emergency room “when there is no other option,” Bortolleto said, or community health centers, which are inundated with patients, shes aid.
Then, the patient receives an exorbitant bill for thousands of dollars.
“It destabilizes their whole life,” Dominguez-Salinas said.
To cover those bills, DominguezSalinas said she has to work with different health care providers to see how to get the cost down and what types of payment plans would be feasible.
Even then, she knows clients question whether to attend follow up appointments to finish treatment and get their health on track while racking up debt, or not and save money.
Her clients have to make lifechanging decisions, not just regarding health care, with their funds regularly.
“Every day our clients are having to choose between paying a bill, or paying for food, or paying for their gas for their car if they can drive a car versus paying an immigration attorney,” Dominguez-Salinas said.
“Health care is a human right,” she said.
Dominguez-Salinas said providing health care to every qualifying undocumented resident would, in the long run, save the state money. The basic care could help people “prevent these big emergencies from happening,” she said.