En Español.

Immigrant youth who get a reprieve from deportation under the Deferred Action for Childhood Arrivals (DACA) program may face a serious problem: lack of access to affordable health insurance.

By expanding both Medicaid and state exchanges that offer affordable coverage, the Affordable Care Act, also known as Obamacare, aims to make insurance mandatory for all United States citizens and permanent residents. Although deemed “lawfully present” by the government, Deferred Action participants will be restricted from these benefits and subsidies.

In San Francisco alone, the Migration Policy Institute estimated that at least 4,500 youth are eligible for DACA, which was announced by the Obama administration on June 15. Candidates for the program are people under the age of 30 who came to the United States before age 16. They must currently be students, have a high school diploma or GED, or have served in the military.

Doreena P. Wong is a project director at the Health Access Project at the Asian Pacific American Legal Center, a member of the Asian American Center for Advancing Justice. She is disappointed that these young immigrants won’t be able to take advantage of what she called the “most significant reform in our health care delivery system since Medicare was established in 1965.”

“There was a recognition that many young people could not afford insurance and had no access to health insurance,” Wong said in an email. To combat this, the Affordable Care Act has made it possible for Americans under the age of 26 to stay on their parents’ insurance; however, this benefit of the health care overhaul will also be denied to those participating in DACA. “This is quite tragic and unnecessary,” Wong said.

This lack of access to health care may be an additional barrier to integration for young immigrants. “They are contributing to the economy and the development of our country, and they are not recognized for the work that they do,” said Laura Melgarejo, a community organizer at the Mission-based advocacy organization People Organizing to Demand Environmental and Economic Rights.

“It’s only showing us that our policy makers don’t understand our community…. Politicians are not doing the right thing for the community that is the most vulnerable,” she said.

Melgarejo believes the lack of access to coverage will cause a larger public health issue within the Latino community. “If we prevent something now, we are investing in the future,” she said. Insurance would make the routine visits that could prevent sickness later in life more affordable, something imperative to the community’s future prosperity.

Despite restrictions to Obamacare, uninsured immigrant youth in San Francisco still have access to affordable services through the city’s Healthy San Francisco program. Residents are eligible if they have an income at or below 500 percent of the federal poverty level: $54,480 for one person and $111,720 for a family of four. It is available to all county residents regardless of their immigration status.

Hilary Rosen, legislative aide to District 9 Supervisor David Campos, called the health care limitations a “tragedy,” but pointed out the value of Healthy San Francisco as an alternative. “I feel very grateful that we have a universal health care system here in San Francisco that doesn’t treat immigrants as second-class citizens,” she said.

While Healthy San Francisco is an excellent resource for primary care, it doesn’t take the place of insurance. The program does not cover enrollees while they are outside of city limits, and it doesn’t extend to hospital and specialty care or cover vision and dental care.

Healthy San Francisco “is a great program, but it has its limits,” said John Gressman, a co-founder of Healthy San Francisco and current president and CEO of the San Francisco Community Clinic Consortium, a nonprofit organization that represents 10 clinics in underserved areas of the city, three of which are in the Mission, and implements Healthy San Francisco.

“The scope of benefits may not be as extensive as insurance, but at least it’s better than figuring it all out yourself,” Gressman said. “In the best of all worlds, the Affordable Care Act would cover all people, blind of immigration status. If a person is sick, they’re sick; why should they have to face horrible costs?”