title: Inclusion of immigrant families in U.S. health coverage expansions.
abstract: This paper examines federal and state restrictions on immigrants and the negative impact of these restrictions on local efforts to serve the uninsured. It examines a health coverage program offered to low-income residents in Alameda County, California from 2000 to 2005, illustrating local efforts to expand health coverage to both adults and children, regardless of immigration status. After five years of operating the pilot program, leaders of Alameda County's health care safety net conclude that local health coverage programs are unsustainable over a long period of time without significant federal and state support. The financial resources that federal, state, and local governments are patching together for health coverage could be used more efficiently if consolidated. Stabilizing the federal tax base and recognizing the phenomenal amount of federal, state, and local funding that is already spent on medical care for the uninsured are the first steps towards achieving meaningful health care reform.
authors.affiliation: Asian Health Services, Oakland, CA, USA. shirota@aol.com
authors.forename: Sherry
authors.initials: S
authors.lastname: Hirota
authors.forename: Jane
authors.initials: J
authors.lastname: García
authors.forename: Ralph
authors.initials: R
authors.lastname: Silber
authors.forename: Ingrid
authors.initials: I
authors.lastname: Lamirault
authors.forename: Luella J
authors.initials: LJ
authors.lastname: Penserga
authors.forename: Margo B
authors.initials: MB
authors.lastname: Hall
mesh_terms: D002140:California; D014487:Centers for Medicare and Medicaid Services, U.S.; D018672:Community Health Planning; D003153:Community Health Services / Q000191:economics*; D004641:Emigration and Immigration; D005192:Family Health / Q000208:ethnology*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage; D017057:Medically Uninsured / Q000208:ethnology*; D011203:Poverty / Q000208:ethnology*; D016730:Program Development; D011632:Public Assistance; D013221:State Health Plans; D014481:United States; D035862:Vulnerable Populations / Q000208:ethnology*