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Buffering the Uneven Impact of the Affordable Care Act: Immigrant‐serving Safety‐net Providers in New Mexico
Author(s) -
Getrich Christina M.,
García Jacqueline M.,
Solares Angélica,
Kano Miria
Publication year - 2018
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1111/maq.12391
Subject(s) - safety net , immigration , bureaucracy , negotiation , health care , business , nursing , immigration reform , uncompensated care , health insurance , public relations , economic growth , medicine , political science , immigration policy , environmental health , medicaid , law , economics , politics
Abstract We conducted a study in early 2014 to document how the initial implementation of the Affordable Care Act (ACA) affected health care provision to different categories of immigrants from the perspective of health care providers in New Mexico. Though ACA navigators led enrollment, a range of providers nevertheless became involved by necessity, expressing concern about how immigrants were faring in the newly configured health care environment and taking on advocacy roles. Providers described interpreting shifting eligibility and coverage, attending to vulnerable under/uninsured patients, and negotiating new bureaucratic barriers for insured patients. Findings suggest that, like past efforts, this recent reform to the fragmented health care system has perpetuated a condition in which safety‐net clinics and providers are left to buffer a widening gap for immigrant patients. With possible changes to the ACA ahead, safety‐net providers’ critical buffering roles will likely become more crucial, underscoring the necessity of examining their experiences with past reforms.

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