After many years of persistent advocacy, Idaho voters passed a ballot initiative in 2018 in favor of expanding Medicaid, and health coverage for the newly eligible is scheduled to begin on January 1, 2020. Medicaid enrollment officially began on November 1, 2019 and marked the beginning of what is supposed to be a celebratory time after a hard-fought battle. However, this health care victory comes with a stark reminder that barriers to access still exist in Idaho and elsewhere for those who are impacted by our nation’s failing immigration system.

In 2016, Community Catalyst began a partnership with Centro de Comunidad y Justicia (CCJ) and encouraged them to collaborate with Idaho Voices for Children on statewide efforts to close the Medicaid coverage gap. As Idaho now moves toward implementing Medicaid expansion, a new tension has emerged for Latinx families.

This past August, the Trump Administration announced changes to the public charge rule. This harmful policy has created fear within immigrant communities by penalizing people applying for citizenship if they enroll in and use social services like Medicaid, including the Latinx community of Boise, Idaho. Although the changes to public charge have been halted temporarily pending court review, CCJ has seen first-hand the “chilling effect” of this public charge rule on members of their community. This includes shorter lines at community health clinics and community members asking the clinic staff “am I safe here?” Idaho has also seen a sharp decrease in the number of eligible children being enrolled in Medicaid. All of this means one thing: Latinx immigrant communities are losing out on health care for which they qualify.

Despite the major success of Medicaid expansion, which will positively impact many Latinx people, CCJ is now working on the next phase in the fight for health care access — empowering immigrants to make the best health care enrollment decision for them, and for their U.S. Citizen children.

In 2018 and 2019, CCJ received a grant from Community Catalyst’s Health Justice Fund to assist in broadening its community outreach to educate people about Medicaid. Members of Latinx communities have powerful stories of how Medicaid coverage has helped improve their quality of life, including how being caught in the coverage gap has harmed them. After all, it was in major contribution to the brave Latinx community activists who shared their stories as part of the ballot initiative – and later in front of the Idaho legislature – that paved the way for passage and implementation.

CCJ is again mobilizing to reach those who speak Spanish and English, in schools and at Latinx community events. Tabling at local events is a key component of building trust within the community and allows CCJ to inform members of the Latinx community of their rights, and updates them on the current status of Medicaid expansion, including who is eligible to enroll.

“Children need good health. Without [health care], without coverage, cycles of poverty cannot be broken.” Enrique Munoz, Medicaid Outreach Specialist who does much of the tabling on Medicaid for CCJ shares, “And the health of children impacts them for the rest of their life and for future generations.”

CCJ is empowering members of the Latinx community to share their stories and experiences accessing health care coverage because they matter. According to Enrique, “As much reach as [CCJ] has, the fear of public charge is on everyone’s mind.” This manifests with an unwillingness of Latinx community members to publicly share their stories. For example, he has spoken with a woman in her late 30s in Nampa, ID who will qualify for Medicaid in January which will allow her to continue to access needed mental health care to treat schizophrenia, depression, and anxiety. Although she is not willing to be publicly identified, she has shared that the care she will be able to receive through Medicaid, including in-home support with tasks of daily living, will be life-changing.

Pushing forward with Medicaid expansion, and combatting the fear generated by public charge requires the voices of many. For more than 20 years the Centro de Comunidad y Justicia has been in the fight, and they will continue to lift up the voices of those in their community who need to be heard.

Tiffany Rodriguez, Together for Medicaid Graduate Intern