Giving undocumented people access to affordable health care is a moral obligation and smart policy

Legislature considering offering MinnesotaCare to immigrants without status

May 10, 2023 6:00 am

A two month old receives drops of children’s Tylenol after getting a vaccination at a low-cost clinic Photo by John Moore/Getty Images.

I’m a medical student interested in primary care, having spent my early adulthood in rural Minnesota with my family as asylees, where we experienced tremendous barriers accessing health care. 

Now, my experience informs my support for a proposal at the Legislature to include immigrants without status in MinnesotaCare, the state’s public health insurance program for the working poor. This is a population is slipping through the cracks within our health care system. Everyone needs and deserves access to health care, including hard working immigrants who are socioeconomically disadvantaged.

When I was 19 years old, my family sought asylum in the United States to escape ethnic genocide against tribal populations in our traditional homeland in Bangladesh. We found refuge at my uncle’s home in rural Saint Charles, Minnesota, and we worked as farmworkers. We worked multiple jobs and minimized our expenses. 

Unfortunately, affordable processed American food replaced our traditional diet, elevating my dad’s blood sugar levels and causing non-healing wounds on his edematous legs. We ultimately decided to take him to a doctor, but local rural health care providers only accepted patients with health insurance, which was not available through our employer. We were also ineligible for public insurance due to our immigration status. 

With my very limited English, I worked three jobs to pay the exorbitant price of private health insurance for my parents, only to find out that their preexisting conditions would not be covered through our insurance plan. As my father eventually could not work or even walk across our living room, I was frustrated and disturbed by the lack of health care access. 

Fortunately, I found a volunteer-run safety net clinic that accepted the underinsured and provided affordable medications to manage my dad’s diabetes. I started to volunteer at safety net clinics for the uninsured, which made me realize the significant number of immigrant patients who are left out of our health care system.

I realized how profound of an issue access-related barriers for immigrants can be. And, for me, it meant working three jobs to afford a private insurance plan that still could not provide my dad coverage for basic diabetes care. 

Across Minnesota, advocates, workers, faith leaders, medical professionals, hospitals, health plans and medical associations agree that immigrants without status should be able to enroll in MinnesotaCare, paying the same sliding scale premium as everyone else.

Denying health care to the immigrant population irrespective of immigration status — including thousands of workers who served on the frontlines during the critical months of the pandemic — does not serve the moral, economic or public health interests of our state.

As a state that values fairness and equality, we must ensure that all members of our community have access to the care they need to stay healthy and thrive. We cannot turn a blind eye to the suffering of our neighbors who have heavily contributed to the prosperity and stability of our state — paying millions of dollars in taxes each year — while also navigating a global pandemic, chronic illnesses, and injuries without health coverage. Immigrant rights issues are human rights issues. 

Allowing immigrants without status to enroll in MinnesotaCare will benefit the health of the state, preventing costs associated with emergency or urgent care. When people lack access to health care, they are more likely to delay treatment, leading to more serious health problems and increased health care costs in the long run. By making primary care accessible through early intervention, we can help ensure that everyone in our community has access to the care they need to stay healthy and manage chronic conditions. We can also immediately reduce the growing racial disparities in health coverage.

Finally, expanding MinnesotaCare coverage to undocumented immigrants makes good economic sense. Minnesotans without status play a significant role in the state’s economy and workforce. When poeple lack access to health care, they are more likely to rely on emergency services, which are more expensive and less effective than preventive care and managing care of chronic conditions. Health consequences can have a cascading effect, leading to more uncompensated care for hospitals, added strain to emergency departments, and loss of work and family support due to illness and injuries.

My family’s health care journey as immigrants in the great state of Minnesota motivated me to seek a career in primary care, advocacy and community organizing. Our collective journey motivated me to be a doctor for immigrant communities because I understand what it’s like when your loved one’s health is rapidly deteriorating and you’re uninsured. 

Everyone in our community should have access to the care they need to stay healthy and thrive.

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Koushik Paul
Koushik Paul

Koushik Paul is a University of Minnesota Medical School student and MD candidate for the class of 2025. He's on the board of directors at the Dakota Child and Family Clinic as the diversity, equity and inclusion director, and on the board of directors of Minnesota Doctors for Health Equity.