How will unauthorized workers get COVID-19 healthcare?

The pandemic puts a lot of things into sharp relief, including how unauthorized persons access healthcare. The data suggests that, at best, less than a quarter of unauthorized persons have assured health access through insurance, compared to over 90% of the rest of the country.

The  10.5 million unauthorized population often use community health centers for primary care. They are ineligible to enroll in Medicare, Medicaid, or CHIP or to purchase coverage through the ACA Marketplaces.

About 8 million are estimated to be employed, at a higher rate of workforce participation than the authorized workforce. But they tend to work for employers that do not offer healthcare, or if it is offered, the unauthorized worker does not enroll. And many are self-employed.

About half of undocumented workers are high school dropouts. That implies an annual income of the undocumented workers at about $25,000 vs the national average of about $37,000. (Also see here.) $25,000 is about equal to 133% of the Federal Policy Level for one person in the household and less than 133% of the FPL for a three person family. 

Enrollment in employer-based insurance declines with wage income. And the percentage of low wager earners covered by employers has been declining.  The table below is based on FPL. the typical unauthorized worker is probably around 150% FPL.



Take farm workers. About one half of all wage (non-family) farm workers are unauthorized. Farm workers are overall far less likely to use health insurance to pay for healthcare. A 2011-2012 survey is dated and covers all workers, but is suggestive of coverage today among unauthorized farm workers. It reported that 34% respondents had health insurance (presumably private). 34% of respondents or someone in their household were covered through Medicaid. Only 55% of respondents stated that their employer provided lost wages benefits for a work-related injury or illness.

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