Wednesday, January 23, 2019

Healthcare Uncertainty for Refugees

Uncertainty: Healthcare for Refugees and the Improvements We Need to Ensure Access 

Clark Campagna, MPA Candidate 

The AGI Rome on forced migration and refugees focuses on non-profit services supporting refugees. Over the course of the week long program, one theme that we explored was the provision of health care services. For instance, we met with Doctors Without Borders, who provide specialized health and mental care services to survivors of torture and clinical care to clients at three operation centers throughout Italy.

Upon my return home, I was inspired to learn more about the provision of health care to refugees in the United States. U.S. government policies provide health care to refugees when they first arrive in the country. When refugees arrive in the United States, the Department of State requires refugees receive “core resettlement services” for 30 to 90 days. These services include “a health assessment, referrals to specialty and mental health care, and ideally, linking refugees to a medical home” (McNeely and Morland, 2016). Refugees receive health care funding through Medicaid for 3 months when they arrive in the United States. After this time expires, refugees may be eligible to receive health care funding through state run programs. (Philbrick, Wicks, Harris,& Van Vooren, 2017). Refugees who do not qualify for such programs, can receive care through the Office of Refugee Resettlement for up to 8 months after their arrival in the United States. When the eight months expire, refugees must secure care on their own (McNeely and Morland, 2016).

While the policies above provide health care for a limited time, structural barriers exist in refugee’s access to care (Philbrick, Wicks, Harris, & Van Vooren, 2017). For instance, refugees experience lag time in accessing Medicare upon arrival in the United States. Language and cultural barriers limit health care access and usage (Philbrick, Wicks, Harris, & Van Vooren, 2017). Kaiser Health News notes that it can be difficult to find a sufficient number of medical interpreters who can support the refugee community. Language also has an effect on mental health services. The Conversation reports that mental health providers may not speak the same language as the refugee community they hope to serve. Additionally, refugees are “often stymied by the paperwork and bureaucracy so unlike what they had back home” (Kaiser Health News, 2018). Women face barriers in accessing reproductive health services including abortions. Just 17 state Medicaid programs provide financial support to women seeking abortions.

The United States must develop policies and procedures to ensure refugees have access to health care. The policies elaborated above provide health care to refugees during their first 6 to 8 months in the United States, but more needs to be done to ensure timely connection to Medicaid and state run programs. Additionally, the United States needs to address inequities in access caused by language and cultural barriers. Innovative and creative solutions exist. Model Media examined a trauma treatment center in Michigan that utilized dance and yoga to help children address their anxiety. By examining and improving our health care for refugees, we ensure the long term health of the newest members of our communities.