Immigrants’ Experience with Medicaid Enrollment: Challenges and Recommendations

The Medicaid enrollment process can be very challenging for people from diverse immigrant backgrounds, especially when they have limited English proficiency, lack computer access, and don’t have an understanding of the complex U.S. health insurance system. This qualitative interview study was carried out with 20 immigrant and refugee New Yorkers “from different countries, living in different parts of the state, and with different immigration statuses” who share their negative and positive experiences with accessing the Medicaid system. Findings are summarized in four brief reports that focus on the following topics: “Navigating Challenges of the Medicaid System”; “Impacts of the Public Charge Rule on Immigrant New Yorkers”; “Experiences of Discrimination and Unwelcoming Medicaid Personnel”; and “Lessons Learned: Community-Based Organizations Are a Key to Immigrant Medicaid Enrollment.” In these reports, the author discusses a number of systemic, cultural, and administrative challenges including: language barriers, access to technology, anxiety created from the Trump Administration’s radical changes to the public charge rule, interacting with unwelcoming Medicaid employees, a lack of knowledge about the enrollment process, and feelings of discrimination based on race, gender, language, religion, or culture. Despite these challenges, many immigrants were grateful to the Medicaid program for providing them with access to health care that they would not have received in their birth country. A key study recommendation is that “the state should promote, advertise, and encourage immigrants to use navigators at community-based organizations and trained enrollers to ensure that immigrants have a less difficult time applying, they understand the requirements, they have access to a translator and more.” (Robert Like, MD, MS)

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