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Current literature indicates an increased disease burden among refugees resettled worldwide as well as in the U.S. Both prevalence and incidence of infectious diseases, chronic diseases, and health conditions are high or higher compared to the general American population. The question raised is how well refugee populations have been responding to their medical expenses. The purpose of this study is through a systematic literature review to identify the challenges of accessing health insurance among U.S. refugees, and to advocate for a healthcare policy change. More than 400 peerreviewed journal articles and book chapters obtained from major databases, and published between 2005 and 2018 were reviewed. Fourteen articles related to the U.S. refugees and health insurance, were included in the final analysis. Seven themes emerged. Results suggested that (1) Compared to the general or minority populations, U.S. refugees were more likely to be uninsured or underinsured; (2) Refugees demonstrated the unaffordability of medical co-payments; (3) There was a lack of full coverage of medical needs; (4) There was a lack of affordable private insurance plans; (5) There was a lack of understanding of the U.S. health insurance application; (6) U.S. refugees struggled to navigate both government and private health insurance; And (7) Refugees had difficulty in understanding the U.S. healthcare policies. More research is needed to specifically examine the accessibility and affordability of health insurance among multiethnic refugee populations in the U.S. Social determinants (e.g., employment, education, and income) should also be addressed in consideration of getting refugees fully insured.

A Review of Refugees’ Access to Health Insurance in the USA