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  1. Intro to recommendations
    As conveyed, the disparity in health care access between the Mexican immigrant community and every other group in the United States is a tremendous problem with many facets. Given that, the following are several recommendations, which, taken together, would serve to curtail the existing barriers faced by Mexican immigrants as they seek access to health insurance and health care in their new home – the United States.
  2. Expand access to coverage through government programs such as Medicaid and CHIP
    • While PPACA is extending coverage through state health exchanges and through an expansion of Medicaid, immigrant pregnant women and children legally residing in Texas will continue to lack eligibility for Medicaid or CHIP if they have been in the state for less than five years; undocumented immigrants will remain ineligible permanently.
    • Texas and other states with such policies have the option to review their regional rules and to disregard this five-year eligibility requirement.
    • “Women without access to prenatal care are four times more likely to deliver low birth weight infants and seven times more likely to deliver prematurely than women who receive prenatal care.”
    • This is just one example of how coverage for these individuals would result in less extraneous hospitalizations and thereby reduce significant medical costs for local governments whose budgets are already strained.
  3. Provide incentives to employers for offering health coverage
    • concentrate on small businesses and businesses that hire many immigrants, such as construction and cleaning firms, and incentivize them to provide insurance
    • coverage for all categories of staff. For example, New York State’s Healthy New York (NY) program provides financial incentives for employers and establishes state-supported benefit packages via HMOs to motivate employers to supply health insurance coverage to their employees.

    consider developing policies ensuring that all full-time public employees have health insurance coverage. This coverage should be affordable and also include provisions that allow employees to extend it to their family members.

    could also adopt policies requires all private sector companies they engage for services, including construction, janitorial and other sub-contractors, to provide an affordable health insurance option to their employees and their families.
  4. Promote access to medical interpretation and translation services
    • A patient’s understanding of the information from health care providers and insurance companies is critical to both the quality of the health care he or she receives, as well as ensuring that individuals are enrolled in health insurance in the first place. Increasing the availability of medical interpreters is crucial to minimizing language barriers that discourage health care access among Mexican immigrants. One example of a successful program addressing the language barrier is the
    • Minnesota Department of Human Services Limited English Proficiency (LEP) Initiative, which offers reimbursements for interpretation services to health
    • care providers. The LEP Initiative has low overhead, while enabling professionals to provide quality interpretation services that greatly improve access to care among the Spanish speaking population. Challenges in adopting or replicating this program is that providers may be disinclined to pay for interpretation services and wait for reimbursement, especially when considering the promptness, precision, and state reply to requests for reimbursements. However, this model serves an example of the viability of acquiring, adopting or replicating medical interpretation and language services. The inability to understand a health care provider’s advice or even communicate with one may ultimately deter patients from attempting to understand the complex U.S.
    • healthcare system, let alone ever seeking health care. Even if immigrants had access to health care
    • coverage, not utilizing it is essentially synonymous with the lack of health care coverage when viewed in this
    • context. In order to minimize this barrier, consider promoting access to medical interpretation and translation services.
  5. Support community health workers (also known as “promotoras”)
    • Community health workers (CHWs) are individuals serving their respective communities in a
    • variety of roles including, but not limited to, health educators, patient advocates, outreach workers, service
    • navigators, and health care delivery team members.
    • Extensive research conveys the involvement of community health workers on access to care. Due to these health workers’ intimate relationships with the community, CHWs can alleviate individual and cultural
    • obstacles faced by patients that inhibit their access to health care. Therefore, the state should also consider supporting community health workers, also known in Spanish communities as promotoras, in order to increase access to health care for Mexican immigrants.
  6. Conclusion
    We have explored an important problem facing the state of Texas and the United States: lack of access to health care for Mexican immigrants residing in the U.S. The research shows that the Mexican immigrant population in this country is insured at a lower rate than any immigrant group, regardless of age, time in this country or occupation. Given the data and the negative implications we have presented, it is vital that we take action at the local, state and federal level to curb dangerously low insurance rates and health care access among Mexican immigrants.
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