142nd APHA Annual Meeting and Exposition

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306955
Characteristics of the Undocumented Young Adults Eligible for the Deferred Action for Childhood Arrivals Program and Policy Solutions to Improve Access

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014

Nadereh Pourat, PhD , Department of Health Policy and Management, UCLA Fielding School of Public Health/UCLA Center for Health Policy Research, Los Angeles, CA
Laurel Lucia, MPP , Center for Labor Research and Education, University of California Berkeley, Berkeley, CA
Max Hadler, MPH, MA , UCLA Center for Health Policy Research, University of California, Los Angeles, Los Angeles, CA
Claire Brindis, DrPH , Bixby Center for Global Reproductive Health & Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Ken Jacobs, BA , UC Berkeley Center for Labor Research and Education, Berkeley, CA, CA
Rachel Siemons, BA , Joint Medical Program, University of California Berkeley, Berkeley, CA
Efrain Talamantes, MD, MBA , Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA
Marissa Raymond-Flesch, MD, MPH , Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, CA
Background:  Over 11 million undocumented immigrants live in the United States.  The Deferred Action for Childhood Arrivals (DACA) program grants temporary legal status to select undocumented immigrants ages 15-31.   Although the Affordable Care Act (ACA) increases health coverage, undocumented immigrants, including DACA-eligibles, remain ineligible for the ACA’s Medicaid expansions and insurance exchanges nationally. In California, individuals granted DACA are Medi-Cal-eligible under state policy. Little is known about this population or their health care access and utilization.

Methods: This mixed-methods study used 28 key informant interviews and data from the California Health Interview Survey to characterize the demographics and health needs of California’s DACA-eligible population.

Results: California’s DACA-eligible population is predominantly Latino (82%), with 60% ages 15-18. Most DACA-eligible children live in low-income households (93%) and 62% of adults are low-income. DACA-eligible Californians are more likely than US-born individuals to lack a regular source of care (37% vs. 28%) and have no doctor visits in the past year (32% vs. 21%) despite higher self-reported rates of poor health (21% vs. 11%). Key informants recommend expanding ACA eligibility, maintaining and expanding state and local programs for populations ineligible for ACA benefits, passing comprehensive immigration reform, and ensuring that public insurance workers understand immigrant enrollment eligibility.

Conclusions: DACA-eligibles have limited access to health coverage and routine care. Lack of receipt of essential preventive and primary care services can lead to avoidable and costly service use and an increased burden on safety net providers. Expanding coverage opportunities for this population is a public health priority.

Learning Areas:

Public health or related public policy

Learning Objectives:
Compare the demographics and health status of the DACA-eligible population in California to US-born peers and identify strategies for improving access to care for DACA-eligible people and other undocumented immigrants.

Keyword(s): Immigrant Health, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Nadereh Pourat is a senior researcher at the UCLA School of Public Health and the director of research at the UCLA Center for Health Policy Research. Her research focuses on disparities in access to health care of underserved populations. She has extensive experience with design and analysis of survey data including the California Health Interview Survey. She has extensively published in these areas.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5008.0: Access to health services for Latinos