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Behind the Numbers: Insurance and Immigration

A young mother can't get health coverage two decades after she immigrated

May 8, 2024

Luisa’s mother brought her to the United States from Portugal at age 7, searching for the American Dream. She’s now 26, with a daughter of her own. But her undocumented immigration status keeps her from services many people take for granted, like health insurance.

“I haven't been able to visit a dentist since I first entered the U.S,” Luisa said.

Oral health is just one of her many concerns. She lives with the constant fear of any health issue bringing an unbearable financial burden.

Luisa is a part-time med spa technician, juggling various other jobs to meet the escalating costs of living for herself and her daughter in Denver. Her daughter is a U.S. citizen and has full health coverage through Medicaid. But Luisa can count on one hand the number of times she’s been to the doctor since arriving in the United States — including her pregnancy.

“It's also challenging to establish a relationship with a primary doctor, so the only time I find myself in a medical facility is during emergencies,” she said. ”Even then, I avoid it at all costs because a simple walk-in can cost me $1,000. Accessing regular health care without breaking the bank has been an unattainable luxury for me.” 

Since 2015, Colorado’s uninsured rate has remained stuck at around 6.5% of the population. (It dropped temporarily to 4.6% in 2023, thanks to a now-expired pandemic emergency rule that kept people on Medicaid.) 

Nearly a third of Colorado’s uninsured are immigrants who lack documentation, according to estimates by the Colorado Health Institute.

Luisa is one of them, and until recently, there were few options for her.

Some health clinics specifically focus on people without documentation, but Luisa said that these options are often so limited that she misses out on opportunities if she's not vigilant.

“I'm really busy trying to raise my daughter, ensuring she gets health care, and providing enough income for us to keep our heads above the rising prices. Most times, my own health care is the last thing on my mind. But then I get sick or an emergency hits, and it's like I can't afford to be sick. I need to work; I don't have time to find an affordable clinic or sign up for their waitlists for sliding scale services,” she said.

In 2023, the state started offering OmniSalud, a health insurance program for undocumented Coloradans. Luisa tried to enroll, but all slots for affordable plans were filled before she could even speak to someone.

“I tried shopping for my own health insurance,” she said, describing the experience as “laughable” due to the high costs. With her finances stretched thin, she cannot afford an extra $300 to $500 a month for a basic health plan.

“It's really frustrating. The system seems like it's always been set up for me to fail. I want the best for my daughter, and I feel like I have had to forfeit my own health for that. But I feel like there should be better systems in place,” Luisa said.

“I'm really busy trying to raise my daughter, ensuring she gets health care, and providing enough income for us to keep our heads above the rising prices. Most times, my own health care is the last thing on my mind."