Bioethics Forum Essay

Undocumented Patients in the Local Safety-Net: Tools for Teaching, Learning, and Practice

The 11 million undocumented immigrants in the United States live in all 50 states and rely on local safety-nets and state-level provisions for health care. Launched in 2011, The Hastings Center’s Undocumented Patients project has focused on understanding ethical and policy challenges in providing health care access for this low-income population, which is excluded from key federal benefits and faces uncertain prospects.

The Undocumented Patients website is a hub for issue briefs, policy solutions, and a searchable database of research tools on this issue. The following web-based tools have been selected by project staff to help professionals who work in safety-net hospitals, clinics, and health programs learn about the demographics of the undocumented population in a state or county. These tools also provide up-to-date information on insurance, legal rights, and legal services relevant to the care of undocumented immigrants and mixed-status families. Information and links are current as of January 19, 2017.

For the basics about the undocumented population and migration trends in your state

Pew Research Center

• Annual reports and interactive maps provide reliable estimates based on U.S. Census Bureau data
• State level data sets available in report, table, and map formats

For demographic detail relevant to health care access in your state

Migration Policy Institute (MPI)

• Interactive map with state-level profiles includes countries/regions of origin, insurance access, and language proficiency, with additional detail for more than 100 US counties (scroll down below map for county profiles)
• Frequently Requested Statistics on Immigrants and Immigration is a helpful quick reference

For information about state-level health insurance coverage

Henry J. Kaiser Family Foundation (KFF)

• Annual reports on Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies include state-level information on eligibility for undocumented immigrants
• Table 3 of 2017 report lists states offering CHIP coverage to income-eligible undocumented children using state funds
• Table 4 of 2017 Kaiser report and 2014 Undocumented Patients Project/Hastings Center issue brief provide state-level detail on coverage for prenatal services
• 2016 Undocumented Patients Project/Hastings Center issue brief provides additional state-level detail on Medicaid access for some undocumented immigrants

For information about legal rights relevant to health care access

National Immigration Law Center (NILC)

• “Know Your Rights” resource on health insurance and health care offers detailed information, in English and Spanish, on the health-related and Constitutional rights of undocumented immigrants.

For information about hospital-based legal services for low-income patients

National Center for Medical-Legal Partnership

• Interactive map lists participating institutions in 41 states
• Search tools locate services by health care institution or legal institution as well as city or state
• Resources include a guide for legal services in farmworker health programs

Rachel Zacharias is a research assistant and project manager at The Hastings Center.