Eighteen months ago, the New Jersey Legislature approved a proposed expansion of the state’s NJ FamilyCare program, known as the Cover All Kids Initiative, which aims to provide health insurance for all children in the state regardless of immigration status. Gov. Phil Murphy signed the bill into law. This historical piece of legislation for New Jersey and for the nation and should be cause for celebration.
Cover All Kids took effect on Jan. 1 — but very few people know about it. Other than a line of text on the state’s Medicaid enrollment website stating that all children under 19 are now eligible regardless of immigration status, there has been scarcely any mention of it. There is no guide available explaining how parents can apply for their children, and there have so far been no outreach efforts to enroll eligible families in services. We must do better.
As a social worker for the American Friends Service Committee’s Immigrant Rights Program, I strongly support the expansion of public health insurance program to all the state’s children. At the same time, I am disappointed that it took so long to start and no clear effort has been made to inform or engage the thousands of New Jersey families and children whose lives could be changed for the better by this program. I hope this will change starting this month.
AFSC’s social work interns recently conducted a survey of some of the immigrant families on the organization’s caseload to learn whether they were aware of the expansion of Cover All Kids. We wanted to know what these families’ experiences accessing healthcare for their children had previously been like, and what the proposed expansion would mean for them.
Of the families surveyed, none were aware that the proposed expansion of NJ’s Family Care program was taking place until we informed them. Many said that the emergency room was their children’s primary point of contact with the healthcare system.
Their methods of transportation to the E.R. included getting a ride from a friend, taking an Uber (an ambulance could cost thousands of dollars), and, in the case of one mother, walking nearly two miles to the hospital with her four-year-old daughter.
Several clients stated that they had received medical bills in the past year in excess of $1,000. CharityCare is often denied for obscure or seemingly arbitrary reasons — one client’s sale of a pair of sneakers for $200 put him over the income eligibility limit.
For parents who were aware of the state’s existing system of Federally Qualified Health Centers, there were other barriers to receiving care. Prospective patients must often wait months at a time for appointments. Adequate interpretation services are hard to find; Spanish speakers are sometimes fortunate to encounter bilingual staff, but many others are discouraged and made to feel as if healthcare is not for them. Some face explicit discrimination because of their lack of English proficiency, or because of anti-immigrant or racial bias.
Cover All Kids is a welcome first step toward ensuring universal access to healthcare in New Jersey; however, the program will only be effective if people know about it and utilize it. Without a plan to engage the community in services, many of the problems in healthcare access for immigrant families will persist, and thousands of children will continue to lack potentially life-changing primary and preventive medical care.
I urge all policymakers and stakeholders, especially the state government of New Jersey, to spread the word about Cover All Kids and to make sure that it is implemented justly and fairly, with the wellbeing of the immigrant children and families it is designed to serve foremost in mind.
Will Zentmyer is a social worker with the Detention and Deportation Defense Initiative for the American Friends Service Committee.