Supporting Health Care for Every Child in Virginia
By Matt Van de Graaf and Elizabeth Beverly
Among the hundreds of bills considered by the 2022 General Assembly are Senate Bill 484 and House Bill 1012.
These bills would establish a program that guarantees access to health insurance for all children who reside in Virginia, regardless of their immigration status. It is crucial that Virginia takes this opportunity to reach all children and brighten the future of our children and our community.
One of our patients, “Rosa”, is one of many children who face barriers to accessing health care. She is a 5-year-old girl who comes to our free student-run clinic for her routine pediatric care. Seeing Rosa, and so many other patients like her, is one of our favorite experiences as medical students, but it is at the same time frustrating that so many of these children cannot access health care with the same ease as their peers. Many of the children we see have undocumented immigration status and must come to our free clinic because they are not eligible for insurance that would cover the cost of health care at a pediatrician.
Most children living in Virginia get health insurance through one of several options. However, there is one important group that is often overlooked: children who were not born in the United States. Inequalities in access to and use of health care have only been amplified by the COVID-19 pandemic, with millions of children lose their health insurance Across the country. In total, 4.9% of children in Virginianearly 100,000 children are no longer insured.
In Virginia, undocumented children are disproportionately affected, with nearly 50% of them do not have access to insurance. These children do not have equal access to insurance coverage due to restrictions that prevent them from participating in Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act market. They are our neighbors and will undoubtedly contribute to the continued success of our communities. Yet they are excluded from our health care system.
With a higher rate of uninsured people, immigrant families are often forced to delay or forgo necessary care. In fact, the Kaiser Family Foundation Reports that “uninsured children are more likely to have no usual source of care, to delay care, or to have unmet medical needs than insured children”. Even for common childhood illnesses, these children can experience more serious health problems and preventable hospitalizations. We worry about what this means for our patients. What would happen to Rosa when she needed urgent medical attention? What if Rosa had an asthma attack? Would her family have trouble getting the medical care they need? Not only does this inequitable access to health care lead to poorer health outcomes for children, but it also creates an increased financial burden on the entire health system.
Currently, 10 States and Washington, D.C.. use or plan to use state or district funds solely to provide health coverage to income-eligible children, regardless of immigration status. New York has been doing it since 1990 and, in 2019, 97.6% of children in the state now have insurance coverage. In 2021, Virginia reached an important milestone by passing legislation requiring the Virginia Secretary of Health and Human Resources to convene a task force to research and recommend strategies for funding health care services for undocumented children. Although the task force was a constructive step forward, it will only make sense if it results in successful legislation that guarantees access to health care for these children.
When we think of child health issues, a quote from Nelson Mandela comes to mind: “There can be no more accurate revelation of the soul of a society than the way it treats its children. Our community and our country are built on the principle that accepting and nurturing those around us makes us stronger.
Children, like Rosa, are both the most vulnerable among us and also determine the strength of our future as a society. We have the opportunity to raise every child by creating a state that provides health care for all children. In doing so, we nurture the ideas, talents, and cultures of every Virginian and envision a better future for every individual and every community in our Commonwealth. Let us raise our voices and use our presence to stand up for what is right; press our representatives (you can find yours here) to pass this legislation that supports health care coverage and access for every child in Virginia. This is Virginia we want to call home.
Matt Van de Graaf is a permanent resident of Virginia and a fourth-year medical student at Eastern Virginia Medical School. He plans to continue his residency in pediatrics after graduating in May. Elizabeth Beverly was born and raised in Virginia and is a third-year medical student at Eastern Virginia Medical School with an interest in pediatrics. She is the current co-director of Clínica Esperanza, a free, student-run clinic dedicated to providing free health care to the uninsured Spanish-speaking population of Hampton Roads.