HOUSTON — Many immigrant families are
hesitant about applying for government subsidized health
insurance under President Barack Obama’s health care law, worried that providing personal information could draw the attention
of immigration authorities.

Immigrants who are in the U.S.
illegally cannot participate in the system. But many have eligible relatives
who are citizens or legal residents.

Since the system debuted in October,
immigrant advocates and the federal government have been working to reassure
families that their information will not be shared with enforcement agencies.
The effort has led to changes in the main health
care website and a memo from immigration authorities promising not to go after
anyone based on insurance paperwork.

Still, some families remain so
concerned that they would rather see loved ones go without coverage than risk
giving personal information to a federal agency.

 

 Adonias Arevalo spent days trying to
calm his parents’ nerves about the personal information that would appear on
his application. After a week of discussion, the 22-year-old Houston man, who
works at a community center and has temporary legal status, finally eased their
fears.

“They are afraid,” said
Arevalo, whose parents immigrated to the United States from El Salvador seven
years ago. “The majority of families, they know it’s something they need
to do. … They’re just afraid of putting themselves out like that.”

Immigrant families are important to
the success of the health care overhaul, Obama’s most significant domestic
achievement. The program, which has faced fierce opposition from Republicans,
suffered an embarrassing setback when the October rollout of the insurance
enrollment website was mired in technological glitches.

Of the nearly 40 million people living
in the U.S. who were born elsewhere, about a third do not have health insurance, according to census data.
And about 9 million people in the U.S. belong to immigrant families in which at
least one child is a citizen, according to the Pew Research Center’s Hispanic
Trends Project.

 

 Those immigrant families, which tend
to be younger and healthy, are
attractive to the health care program
because it relies on young participants to pay premiums to help fund coverage
for older people who need more expensive care.

Texas has the nation’s highest rate of
uninsured people, many of whom are immigrants.

Meanwhile, the House Oversight and
Government Reform Committee scheduled a hearing in Richardson, Texas to
investigate Obamacare “navigators,” employees who are trained to help Americans
understand and select their new insurance options under the law..

In Houston’s Harris County, where more
than a quarter of the 4 million residents are foreign-born, the group Enroll
America is trying to soothe anxieties that signing up for insurance could mean
risking deportation.

“It has pushed people away from
wanting to apply online,” said Mario Castillo, who leads the group’s
efforts in the Houston area. “They don’t want to type that into a computer
… they want to put a paper application in.”

Cheryl O’Donnell, state director of
Enroll America in Arizona, said her staff is confronting similar concerns.

“There is a lot of fear,
particularly if the noncitizen is applying for a citizen child,” she said.

In mid-October, three weeks after
enrollment opened, the Obama administration stepped in. Immigration and Customs
Enforcement published a “clarification” designed to assuage fears.
The memo explained that information obtained through health care registration would not be used to pursue
immigration cases against anyone in the country illegally.

Jenny Rejeske, a health policy analyst at the National Immigration
Law Center, said advocates had shared with the government concerns they heard
from mixed-status families.

Advocates had sought that
clarification for years, but it wasn’t until federal officials “saw that
this was going to be a deterrent for people applying that they decided to do
something about it,” Rejeske said.

Around the same time, a new page
appeared on healthcare.gov titled
“What do immigrant families need to know about the marketplace?”
Under a heading for mixed-status families, it states: “Family members who
aren’t applying for health coverage
for themselves won’t be asked if they have eligible immigration status.”

It also said that applying to the
insurance marketplace, the Medicaid program for the poor or the children’s
program known as CHIP will not mean immigrants are considered a “public
charge,” addressing a long-held concern that accepting a government
benefit could jeopardize their chance of getting legal status or becoming a
naturalized citizen.

Among the nation’s uninsured children
- regardless of immigration status – 65 percent are eligible for Medicaid or
CHIP but are not enrolled.

Arevalo, who applied for insurance
after talking to his parents, works as a community resources specialist at a
community center run by Neighborhood Centers Inc. He moved to the U.S. from El
Salvador when he was 14 and received permission in March to stay in the country
for two years through a program offered by Obama to some immigrants who were
brought into the country illegally as children.

His new job puts him at an income too
high to qualify for a tax subsidy in the health
care marketplace, though he would also be ineligible due to his deferred
immigration status. Instead, he will have to buy a basic insurance plan through
his employer for about 20 percent of his monthly salary.

But to learn that, he first had to
apply for coverage, and persuading his parents his application wouldn’t
jeopardize them was a significant hurdle.