Barriers

Legislative Barriers

Southern states have imposed legal barriers that limit undocumented immigrants’ healthcare access. Texas and Georgia declined to expand Medicaid under the ACA, leaving many low-income adults without coverage. In Georgia, undocumented immigrants qualify only for emergency Medicaid services. Florida’s SB 1718 (2023) requires hospitals to record immigration status and criminalizes aspects of undocumented daily life, fostering a climate of fear that deters care-seeking.

Economic Barriers

Undocumented workers are concentrated in low-wage jobs that rarely offer health insurance. They are ineligible for public health coverage (like Medicaid or ACA subsidies) due to their immigration status. As a result, uninsured rates are extremely high: about half of likely undocumented adults were uninsured in 2023. Cost concerns also lead many to postpone or skip care to avoid unaffordable bills.

Social Barriers

Fear of deportation and aggressive immigration enforcement creates a “chilling effect” that keeps many from seeking care. Language barriers and limited culturally competent care hinder access for non-English speakers. Discrimination and mistrust further deter care: 25% of immigrant adults reported unfair treatment by providers, and 22% delayed care due to cost or immigration fears.

Sources

https://www.cdc.gov/public-health-gateway/php/about/social-determinants-of-health.html#:~:text=Overview-,Social%20determinants%20of%20health%20(SDOH)%20are%20non%2Dmedical%20factors,that%20shape%20everyday%20life%20conditions.

https://stateline.org/2024/07/19/in-the-10-states-that-didnt-expand-medicaid-1-6m-cant-afford-health-insurance/#:~:text=The%20Affordable%20Care%20Act%2C%20also,Tennessee%2C%20Texas%2C%20Wisconsin%20and%20Wyoming

https://www.kff.org/racial-equity-and-health-policy/fact-sheet/key-facts-on-health-coverage-of-immigrants/#:~:text=they%20have%20more%20limited%20access,those%20who%20are%20eligible%20for

https://www.usf.edu/arts-sciences/centers/iwrc/news/2024/the-health-costs-of-fear-article.aspx#:~:text=hardship%2C%20and%20systemic%20discrimination%20in,2023

https://dch.georgia.gov/programs/hcbs/community-based-services/applying-medicaid#:~:text=your%20age%3B%20whether%20you%20are,eligible%20for%20emergency%20assistance%20only