Effective strategies for Affordable Care Act enrollment in immigrant-serving safety net clinics in New Mexico

The Affordable Care Act (ACA) has been widely viewed as a mechanism for reducing health disparities through expanding insurance coverage and thus healthcare access. However, the ACA distinguishes between lawfully present and unauthorized immigrants, with the latter being excluded from the ACA's insurance enrollment options. This study interviewed healthcare providers at safety net clinics (including community health centers) in New Mexico, one of the country's poorest states whose population is also 47.7% Hispanic (many of whom are immigrants). Providers reported that the ACA led to misconceptions and increased fear among many unauthorized immigrants that they would no longer be able to receive healthcare services at all. Several insights were offered into which strategies for enrolling immigrants in insurance produced the most effective outcomes. Clinics which invested in hiring navigators, trained staff whose primary role was to assist patients with understanding the insurance changes and enroll those who were eligible, had better outcomes than clinics that shifted enrollment to untrained staff. Another effective strategy for clinics to increase immigrant enrollment was conducting outreach, often utilizing community health workers who had already established trust with immigrant communities to facilitate workshops or distribute information. (Immigrant Integration Lab)

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