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The COVID-19 pandemic has revealed that we are only as safe as the most vulnerable among us. In Hawaii, that includes our immigrant family, friends, and neighbors.
Nearly one in five Hawaii residents are immigrants. About half are now citizens, and the rest make up a myriad of different “statuses.”
This includes lawful permanent residents (also known as LPRs), COFA citizens, and asylees. There are also nearly 45,000 undocumented immigrants in Hawaii.
All of these immigrants have something in common — they are our neighbors, the cashiers at our grocery store, the doctors and nurses in our hospitals, and the students in our classes. They are our families. They are us.
Immigrants stand to be the most severely impacted by this pandemic and ensuing recession. As we seek solutions for Hawaii, our leaders must include non-citizens if we wish to beat the virus together.
First, Hawaii should use its power to expand Med-Quest, Hawaii’s Medicaid program, to low-income individuals of all immigration statuses.
Currently, only citizens and lawful permanent residents who meet certain criteria are eligible. Undocumented immigrants and most COFA citizens (with the exception of pregnant women, children up to age 19, and the aged, blind, or disabled) are not. Those in these groups without additional options simply go without any insurance.
The cost of health care has always deterred uninsured individuals from getting care until an illness becomes a true emergency. This is a problem, especially now.
Hawaii’s collective health depends on all of us seeking a doctor’s advice about testing and treatment, without fear, before we become critically ill. Although the federal act provides some testing funding for the uninsured, testing alone is not enough. (On Friday, the president said that the act would also cover treatment in hospitals for the uninsured, but declined to confirm whether this would apply to undocumented immigrants.)
If those without insurance must wait until they are so sick that the emergency room is their only treatment option, they will needlessly suffer and our whole community will be more susceptible to the spread of COVID-19. And denying them health insurance may not save Hawaii money, because the state covers emergency care for uninsured individuals — meaning that we all pay more in emergency costs in the end.
At a minimum, Hawaii should, as New York has done, expand the Emergency Medicaid available to COFA citizens, undocumented immigrants, non-eligible lawful permanent residents, and others to cover COVID-19 testing, evaluation, and treatment — not just emergency services.
Withholding health insurance from our most vulnerable immigrants is bad for our humanity and our collective health, especially during this crisis.
Second, we must protect immigrants losing their jobs.
In Hawaii, the two biggest industries among immigrant workers are accommodation/food services and retail. Like much of Hawaii, these immigrants are hit hard by the state’s stay-at-home and quarantine orders.
For immigrants, though, the harm of business closures is greater because they do not have the same access to public benefits. Federal food stamps and cash assistance programs, for example, are only available to U.S. citizens and limited groups of non-citizens, permanently excluding COFA citizens.
Undocumented immigrants do not even get unemployment benefits, even if they are otherwise qualified through their work history. The new federal CARES Act excludes immigrants without social security numbers or who are considered “nonresident” from receiving stimulus checks.
Importantly, immigrants pay taxes toward these benefits, including Med-Quest. Lawful permanent residents pay taxes. COFA citizens pay taxes. Undocumented immigrants pay taxes.
In 2014, Hawaii households led by immigrants paid $1.2 billion in federal taxes and $668.5 million in state and local taxes. Hawaii’s undocumented immigrants paid about $32.3 million in state and local taxes that year.
Letting our neighbors suffer is cruel, and it also makes us all less healthy. For those still working, immigrants without sick leave may be forced to work through illnesses, and, while that is never good, it is especially dangerous right now.
And for those left without jobs, financial instability jeopardizes their ability to seek care or even stay at home when sick. Health care, unemployment, and other benefits must be available to all.
Finally, the state needs to translate all its announcements related to COVID-19. Over 26% of Hawaii residents speak a language other than English at home.
Although the Department of Health’s COVID-19 website is available in Hawaiian, Chinese, Japanese, Korean, Lao, Spanish, and Filipino — and a flyer is available in additional languages — the website itself still misses key languages like Chuukese, Ilocano, and Marshallese.
We are only as safe as the most vulnerable among us.
The mobile version of the website currently lacks any option for translation — especially harmful when many individuals have access to smart phones before they have access to computers. And the governor’s announcements, noting updates like Department of Public Safety’s suspension of eviction actions, are not translated at all.
There must be translation and meaningful outreach. Our whole community must know all of the facts, news, and directives. Confusion will allow the virus to breed.
COVID-19 attacks celebrities, politicians, laborers, and immigrants without discrimination. If we leave behind any individual, we make our whole community less safe.
This has always been the case, and we are seeing it in the starkest terms right now. We must not hesitate to act.
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