The spread of the coronavirus and the immensity of the public health crisis facing our country has many of us feeling afraid. We’re feeling the heavy burden of wondering whether we, or our friends, or family will get sick. The virus doesn’t stop at borders. It doesn’t discriminate between rich and poor, by race, or country of origin. But the unfortunate truth is that the systems we are relying on to protect us certainly do.
People living in the United States do not have equal access to health care, and the extreme injustice of that fact is crystalizing for many right now. In the US, people of color and immigrants are less likely to be insured. Immigrant women are disproportionately affected by restrictions on getting health coverage with 32 percent of noncitizen immigrant women age 15-44 uninsured. Without insurance, people are forced to rely on community health centers or pay for care out of pocket, and we all know that when health care isn’t affordable, it is often out of reach.
It is policy decisions made by politicians and government officials that have left us in this mess. They have turned immigration status into a barrier to getting health insurance, leaving foreign-born women nearly twice as likely as U.S.-born women to be uninsured. Removing the five-year bar on immigrants being able to enroll in Medicaid and allowing undocumented immigrants to purchase plans from the online insurance Marketplace would be a significant step forward for opening up access to care.
Even now, in the midst of a national public health crisis, President Trump is doing everything he can to dismantle the Affordable Care Act (ACA), also known as “Obamacare.” Millions of Asian American Pacific Islanders (AAPI) got insured through the ACA despite the exclusion of more than 20 percent of uninsured non-elderly Asian Americans because of their immigration status. Still, Trump has stopped the government from reopening the insurance Marketplace so people can sign up for plans during the pandemic and continues to support the lawsuit to throw out the law entirely.
This month also happens to be National Minority Health Month, an annual commemoration established by the Office of Minority Health within the federal Department of Health and Human Services (HHS). This year, for the second year in a row, the theme is “Active & Healthy,” which the administration is using to encourage folks to “stay active” while stuck inside. This is good advice, generally, but intentionally downplays what is really at stake for people of color and how our government is at fault for the burden of preventable disease and death before the arrival of the coronavirus.
One of the major risk factors for coronavirus is pre-existing health conditions. Among the conditions that make catching it more deadly, people of color have higher rates of diabetes and some ethnicities have higher rates of asthma. Socioeconomic status also influences health. Those with fewer financial resources and people of color, once again, are forced to accept a higher risk of exposure to the virus and once they get sick, have fewer resources to get the care they need. AAPI women are overrepresented in the most poorly paid jobs in the nation, serving food, cleaning homes and offices, and caring for children and elderly adults, and are likely to lack health insurance, equal pay, paid sick leave, and paid family leave.
Infectious disease outbreaks have a long history of affecting society’s most vulnerable. The last legislative package from Congress to provide aid to Americans facing hardship in the pandemic and provide free COVID-19 testing to “everybody” left out millions of low- and moderate-income immigrants. Any future legislation must include provisions ensuring coverage for COVID-19 testing and treatment for immigrants of all statuses.
Right now, the federal government isn’t tracking demographic data on the racial and ethnic characteristics of people who are tested or treated for COVID-19, although we know that African Americans are dying from the illness at higher rates than any other group. Senators Elizabeth Warren, Cory Booker, and Kamala Harris and Representatives Ayana Pressley and Robin Kelly have asked the Secretary of HHS to do so, so that disparities in the response to the coronavirus can be addressed as they emerge. This issue is familiar for the AAPI community, which is most often lumped together as one despite consisting of nearly 50 different ethnicities and for whom data collection has failed to capture our diverse experiences.
Existing disparities in our health and access to health care in this country mean that marginalized communities are most vulnerable to the consequences of the coronavirus outbreak. It’s obvious that Trump’s mismanagement means that millions of people will suffer unnecessarily. When we do finally get to the point where we can look back on our nation’s response to this crisis, it will be a mark of shame if people of color and immigrants have been abandoned to face this illness alone at a time when they need help the most.
Sung Yeon is a first-generation immigrant working mom and serves as Executive Director of the National Asian Pacific American Women’s Forum (NAPAWF).