A few thousand children are falling through the cracks of Delaware’s health care system because of their immigration status, according to lawmakers determined to find a solution.
Democrats have introduced a bill to give health coverage to children in Delaware whose families have immigrated to the U.S. illegally.
Bill sponsors expect the bill to cover roughly 2,500 to 5,000 children. It’s not clear exactly how many children would be covered by the bill because families are often fearful of coming forward, according to Rep. Krista Griffith, a Democrat from Fairfax who is sponsoring the bill.
As it stands now, the only coverage that the state and the federal government can provide is life-or-death emergency care, Griffith said.
Under the proposed legislation, children would be eligible for health coverage if they live in the state and their family income is low enough that they would qualify for Medicaid or the Children’s Health Insurance Program coverage.
The bill is expected to affect only children who don’t currently qualify for coverage because of their immigration status.
The Department of Health and Social Services would run the program, which would go into effect in January 2023 if the bill passes. Hospital, medical, dental and prescription drug benefits would align with Medicaid and CHIP coverage, according to the bill.
But the one-page bill could face obstacles from Gov. John Carney’s administration, whose health secretary is hesitant about how the state will pay for it. It’s expected to cost several million dollars per year.
Carney has not commented publicly on the bill but is typically hesitant about any proposals that include a recurring cost such as this one.
The 62-person, Democratic-controlled General Assembly has become increasingly progressive and willing to spend money on similar programs. But Carney, who has traditionally gotten his way in the Statehouse, is by comparison fiscally conservative.
“For thousands of Delaware children … a simple trip to the doctor for an illness or to get vaccinated is not a financially viable option,” Griffith said.
Sen. Sarah McBride, a Wilmington Democrat who is helping sponsor the bill, said the proposal is “financially responsible” because the current system is “inefficient.” By expanding coverage, health outcomes will be improved and overall care costs for the state will go down in the long run, she said.
“None of them chose the broken immigration system that prevents them from seeing a pediatrician, and none of them chose to endure the kind of basic health concerns that afflict so many young people,” McBride said.
Children getting poor treatment under current laws
Two parents who immigrated to Delaware shared examples of their families’ health care challenges when the bill was introduced last week.
One mother, who did not give her name, said through a translator that her 14-year-old has no medical insurance and cannot get a checkup. Routine dentist appointments are too expensive, and she’s limited to only doing the exams mandated by her child’s school, she said.
Once, she took her child to the doctor for a skin problem. She was able to pay for the appointment, but when she went to the pharmacy to buy the medication he was prescribed, she couldn’t afford it.
“One is there with one’s heart torn apart,” she said.
Another mother, who did not give her name, said she had trouble paying $300 for an ambulance to transport her child, at the time a 1-year-old, from the emergency room to the children’s hospital for a respiratory condition.
Her daughter, who’s older, has had fewer health problems. But recently, her teacher asked her family to take her to an ophthalmologist for vision problems. She’s struggling to find care she can afford.
According to Dr. Marisel Santiago, a pediatrician at the La Red Health Center in Georgetown, pediatricians see “heartbreaking” situations when children don’t qualify for health coverage because their family immigrated illegally. Parents struggle to pay for medication, tests and lab work. Some of the children they treat also have “terrible, terrible dental hygiene,” she said.
She remembers one family who brought in their 8-year-old boy, who was severely obese. Doctors said they needed to do lab work on the child, but the family “just disappeared” because they couldn’t afford it, she said.
Eventually, they came back and the child had lost weight despite eating the same and drinking more water. Doctors again ordered lab work, which the family again didn’t do because they still couldn’t afford it.
The child eventually ended up in the hospital with diabetic ketoacidosis, a life-threatening complication, and is now a type 1 diabetic patient, she said.
“The same way that we can provide school and education for every kid, no matter where they come from, we should be able to provide access to medical coverage,” Santiago said.
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Progam not included in Carney’s budget
The state will have to pay the full cost of the program, which would have to be written into next year’s budget by the 12-person Joint Finance Committee that relies mostly on Carney’s spending proposal when drafting.
Carney has not included this bill in his proposal, which he presented in January.
Besides McBride and Griffith, 25 other Democrats have signed on to the bill, which is essentially pledging their vote. But they will need more votes than that to pass it.
According to spending estimates from Nemours Children’s Health and DHSS, it could cost the state between $3 million and $7 million per year, Griffith said.
Carney’s office did not say whether or not the governor supports the bill.
“We’ll be following legislative debate on the bill,” said his spokesman, Jonathan Starkey.
“The real issue will come down to determining (the cost),” Griffith said.
Bill sponsors have pledged to work with the Carney administration on ways to fund it.
The bill won’t be scheduled for a hearing until March, according to a House spokesperson.
The General Assembly is in session until the end of June. After that, they go on a six-month break.
The bill has support from Lt. Gov. Bethany Hall-Long and the Delaware State Education Association.
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Sarah Gamard covers government and politics for Delaware Online/The News Journal. Reach her at (302) 324-2281 or sgamard@delawareonline.com. Follow her on Twitter @SarahGamard.
