Законодательные изменения в США и Северной Каролине ограничивают доступ мигрантов к медицинскому страхованию

Outreach voices in North Carolina worry that recently passed federal and state laws are restricting access to health insurance for immigrants of all documentation levels. President Donald Trump’s budget and tax law, H.R. 1, ended Medicaid, Medicare and Affordable Care Act Marketplace eligibility for many documented immigrants. Meanwhile, House Bill 696, passed by the North Carolina General Assembly, requires the state Department of Health and Human Services to report anyone who lacks a satisfactory immigration status to ICE. Dr. Viviana Martinez-Bianchi, professor of family medicine and community health at Duke University, said these moves will create additional health coverage barriers. "We're really worried because we see that the impact will extend beyond the individuals who lose coverage. When you are in a mixed-status family, fear and confusion will discourage eligible children and other eligible relatives from applying," Martinez-Bianchi said. Martinez-Bianchi said immigrant families already face a host of systemic challenges to attaining health coverage. That includes navigating fear, misinformation, complicated eligibility rules, language barriers and concerns about how information will be used. Republicans in Congress argued H.R. 1 would cut down on Medicaid costs, while work requirements would encourage people to enter the workforce. North Carolina Republicans said they believe the provision would further align the state with federal immigration enforcement. Martinez-Bianchi also runs community engagement for Fostering Insurance Enrollment among Latinos in North Carolina, also known as FIEL NC. She said understanding the health insurance system and culturally competent training can lead to more people accessing care. "What FIEL NC has done is to help replace confusion with trusted, accurate guidance, you know, with education so that members can really understand what are their options for insurance and for access to healthcare," Martinez-Bianchi said. The program provides trainings for health workers, covering areas like health insurance basics, eligibility, ACA marketplace plans, Medicaid, employer-sponsored plans and utilization.