A Wait We Can’t Afford

Posted September 10, 2009 at 2:15pm

Imagine waiting five years to get a cancer screening or another test that can reveal a health problem like a tumor at an early stage.

In fact, current U.S. policy puts an estimated 358,000 people in that unacceptable position: They’re tax-paying legal residents who cannot afford health care services yet must wait five years to enroll in Medicaid.[IMGCAP(1)]

To make matters worse, a proposal that’s now part of the health care reform debate on Capitol Hill would keep the five-year ban in place. Congress should reject that proposal.

Why? It is not only unfair to bar legal residents who diligently pay taxes from accessing routine medical care, it is also a policy that leads to an inefficient — and costly — system of treating patients only in a crisis.

These immigrants lawfully entered the United States and in most cases they’re working at low-wage jobs that do not offer health insurance. They struggle, as generations of immigrants did, to put food on the table or pay the rent. In many cases, they put off necessary health care because they could not pay the doctor.

To be sure, immigrants, like other poor people in this nation, can go to the emergency room and get care. But that’s an expensive and often ineffective way to treat conditions that require ongoing management like diabetes, heart disease or even cancer.

Take, for example, a legal immigrant who gets a diagnosis of breast cancer in the emergency room. She doesn’t have the money to pay for the follow-up chemotherapy or radiation to keep the cancer at bay. And she’d have to wait five years to get Medicaid coverage.

Studies show that even a short wait for treatment could be lethal: Older women whose radiation therapy is delayed for even three months face a much higher risk that the cancer will come back. And at that point, the average cost of their care is nearly $11,000 more expensive than that of women who have gotten timely treatment.

We must provide tax-paying legal immigrants with timely access to essential medical care. We must keep them on the path to becoming healthy and productive U.S. citizens.

Congress should eliminate the five-year waiting period for Medicaid, a step that would allow legal immigrants to get cost-saving preventive care rather than seeking costly crisis care.

Failure to address this issue now means a tumor that’s tiny now will have time to grow and become more deadly; it means a clogged artery will trigger a massive heart attack; it means a diabetic will skip routine care and will require an emergency amputation.

That’s a price that is too high to pay.

Ho Luong Tran is president and CEO of the Asian & Pacific Islander American Health Forum, a national advocacy organization dedicated to promoting policy, program, and research efforts to improve the health and well-being of Asian American, Native Hawaiian and Pacific Islander communities.