Advocates push to expand health coverage for immigrants

Alexandra Lincango used to stay home from work to take care of her son Darek Clavijo when he would have asthma attacks. Sometimes he was so sick he couldn't even walk.

Lincango took him to a health clinic for low-income patients, but she said he was never diagnosed with asthma.

They got some good news though last year, when Connecticut extended healthcare coverage to children 12 and under regardless of immigration status who qualify based on income, as part of the state's Medicaid coverage. That coverage is good until they are 19.

"With the HUSKY he has now -- fortunately, they gave it to kids -- I call right away, they give him a doctor, they see him, and he gets better," Lincango said in Spanish.

Clavijo, who lives in Danbury, is benefiting from an expansion that, even from the time it was won, left advocates wanting more. Advocates are continuing to push to expand the age to enroll and be covered but are holding off on introducing a new bill this legislative session, though they will be holding a rally at the capital on Wednesday.

A bill that would have enrolled immigrants up to age 26 was introduced last year, but it was cut back to age 15 due to the budget. The new enrollment cutoff will take effect this July. The overall coverage expansion to 26 also failed, with the coverage remaining to last until participants are 19.

Lincango, who does not have health insurance herself, said the moment she found out he got insurance was a "huge joy" and it has changed their lives. With the insurance, Clavijo was diagnosed with asthma and several allergies that had been bothering him. He has been able to go to the dentist. And he got glasses.

Darek Clavijo's sister Najely Clavijo, 23, is a Danbury organizer with the advocacy group for undocumented students and families called CT Students for a Dream. The family came to the U.S. from Ecuador in 2014.

"Now that that bill has passed, we're conscious about Darek not getting sick, but at least we're not afraid of him getting the help he needs," Najely Clavijo said. "And I wish it was the same way for other people, too, for those who don't qualify, but this is the reality."

Najely Clavijo said so far the coverage has been very effective for children up to age 13. But many people still don't know about the insurance, something she and other organizers are working on.

The first bill that passed giving healthcare to immigrants regardless of status was in 2021, for children 8 and under and immigrants who are pregnant. It was set to take effect in early 2023, and the 2022 session expanded the enrollment age to 12 for January 2023.

Connecticut joins several other states -- among them Maine, Massachusetts, New York, New Jersey and Vermont -- that offer some form of health insurance to immigrants regardless of their status.

Now, proponents of the insurance who say healthcare is a human right would like to see coverage expanded even more, but the path ahead is not straightforward.

Some people resent their tax dollars being spent on immigrants, especially those who don't have documentation, reflecting the national immigration debate. In the relatively immigrant friendly state of Connecticut, money for expanded health care is extremely tight due to limits on state spending, at a time when public schools, universities and health care for people already covered are all facing cost crises and cutbacks, officials said.

Advocates and lawmakers are hoping to get the age up to 18 through appropriations this year and focus on next year's session to introduce a bill, said Anjali Mangla with the HUSKY 4 Immigrants Coalition, which fought for the bills. This year, they are launching a coalition campaign aimed at expanding their base of support for healthcare access at a rally in Hartford Wednesday.

"We're mainly trying to go through the appropriations committee rather than introducing a new bill," Mangla said. "We're trying to gauge right now the political will for things like this."

So far, enrollment in the new insurance has been "substantially higher than initially expected," said Peter Hadler, deputy commissioner of the state Department of Social Services. Nearly 10,000 children aged 12 and under enrolled for the three different tiers of new insurance as of December 2023.

Enrollment in the new HUSKY is still a small fraction compared to "regular" HUSKY coverage, Hadler said, which allows children to enroll through age 18. As of December, combined Medicaid and CHIP coverage tops 365,000.

Diana Cajelema, of Stamford, enrolled her daughters, ages 3 and 5, for the new insurance by calling Access Health CT, the state's Obamacare market, and said it was easy. Lincango said the same.

Cajelema came to the U.S. from Ecuador two years ago and does not have health insurance. She said her older daughter used to cry at night because tooth cavities caused her so much pain. The dental work would have cost her $18,000, she said, which she couldn't pay.

"It's a help for us, a huge blessing," Cajelema said in Spanish.

Associate Director of the Yale Pediatric Immigrant and Refugee Clinic and Assistant Professor of Pediatrics Julia Rosenberg said she sees relief on parents' faces when they find out they could be eligible for insurance. She wrote in a Yale Pediatrics blog post about one family's experience and the benefits of the insurance.

"The costs that come from not providing the care that we expect children should be able to access come in the forms of those acute care costs, those uncompensated care costs, and then societal costs, where it's missed school days for children, missed work days for parents," Rosenberg said in an interview. "We know that children who are continuously enrolled in health insurance are also more likely to succeed academically, and then become productive members of society."

Hospitals could save up to $72M by reducing spending on uncompensated care according to a 2022 Rand study about insurance coverage for immigrants in Connecticut.

Lawmakers involved in the bill agree that the upfront investment saves taxpayers in the long run.

State Sen. Matt Lesser, D, Middletown, who co-chairs the Human Services Committee, said he hears from some of his constituents that they don't want their tax money to go to paying for children who are not lawfully present. His response is that if you deny children healthcare, the healthcare needs don't go away, they just get more expensive. He recalled the public testimony period of last year's session when people spoke about not treating a broken arm.