This post was updated March 12 at 7:50 p.m.

Undocumented people living in the United States are denied their basic right to health care each and every day, with only a few states choosing to expand coverage to this community.

Undocumented immigrants cannot enroll in federally funded health care programs like Medicaid, the Children’s Health Insurance Program and Medicare and are prevented from purchasing coverage through Affordable Care Act marketplaces.

Consequently, undocumented immigrants in California face significant barriers to medical care. These barriers are not just legal but also economic and social, limiting people from seeking timely and preventive treatment.

“We need a comprehensive health care bill that really includes everyone,” said Ju Hong, director of the UCLA Dream Resource Center – a program dedicated to training young immigrants and allies to become leaders in immigration advocacy. “Health care is a human right, and everyone deserves access to high-quality care.”

Health care should be recognized in the U.S. as a human right that is not limited to communities, families or individuals based on their immigration statuses.

The 1996 Personal Responsibility and Work Opportunity Reconciliation Act restricted undocumented immigrants from accessing many public aid programs, including health care access.

“Immigrants, particularly those who are undocumented, are fearing for their safety and that of their families,” said May Sudhinaraset, professor and vice chair of community health sciences at the UCLA Fielding School of Public Health, in an emailed statement. “We know that undocumented (people) are much more likely to be uninsured compared to their documented peers, and are also more likely to delay care when they need it.”

According to the Kaiser Family Foundation, 50% of undocumented adults in 2023 were uninsured. Undocumented immigrants are the largest group of uninsured individuals in the U.S., according to the National Immigration Forum.

There are many factors that deter undocumented residents from seeking care, including language and cultural barriers. All of these variables unfortunately contribute to a deterioration of health among undocumented people.

Hong said many undocumented immigrants avoid seeking out health care support because of fear and uncertainty.

“It’s hard to reveal status to the public entity or even any institutions (because of) the fear of facing deportation, not only for themselves, but their families,” Hong said.

According to the Migration Policy Institute, immigrants are still less likely to use and access health care services, even when controlling for the effects of race, ethnicity, income, insurance status and health status.

California became the first state to remove barriers for undocumented immigrants, offering all eligible undocumented people health insurance through Medi-Cal beginning in 2024.

The move followed other efforts to expand Medi-Cal coverage to undocumented people in California, including offering it to undocumented children in 2016.

That expansion has already demonstrated promising effects, with 10% more undocumented children reporting they were in excellent health after the expansion was implemented, according to a report from the California Budget and Policy Center.

California is one of only seven states, along with Washington, D.C., with health care programs that cover at least some income-eligible adults regardless of immigration status.

If California can make the step toward guaranteeing health care as a human right, other states can, too. It is time for the implementation of public health legislation on a federal level that guarantees that right.

Asian Americans Advancing Justice Southern California is currently the nation’s largest legal and civil rights organization serving Asian Americans and Pacific Islanders in the U.S. It also works with undocumented individuals from the AAPI community.

“Healthcare access can be challenging even in the best of circumstances,” said Connie Lo, a representative from AJSOCAL, in an emailed statement. “But when an individual is undocumented, challenges are compounded.”

It isn’t strictly a lack of access to medical insurance or federally funded health care coverage that restricts undocumented citizens from accessing medical care. According to a literature review published in the International Journal for Equity in Health, legal uncertainties, economic constraints and cultural disparities exacerbate health inequities for this community as well.

“Addressing these disparities requires administrative and policy advocacy, increased investment in multilingual and culturally competent healthcare services, and a commitment to ensuring that all individuals, regardless of immigration status, have affordable access to quality healthcare,” Lo said in the statement.

Expanding health care access in undocumented communities must therefore adopt a sustained and multifaceted approach.

Anti-immigration advocates and other opponents of such programs, however, often critique their costs.

California’s expansion to include eligible undocumented individuals in Medi-Cal is predicted to cost the California Health and Human Services Agency $2.6 billion annually.

While this program may be expensive, it is dwarfed by the costs of the federal government’s mass deportation policies, whose estimated costs reach into the hundreds of billions or even higher.

Rather than spending so much on immigration enforcement and deportations, those funds could be better redirected into several states’ health care systems to support undocumented patients in need.

Regardless of where we are born, we all deserve health care.

No piece of paper should be allowed to dictate whether our needs are met or forgotten.