Jeffrey Toobin, in his article about the Floreses, a mixed-status family, describes a “comprehensive breakdown in public policy” with regard to immigration reform (“American Limbo,” July 27th). I write as a co-director of the Undocumented Patients Project at the Hastings Center. Families like the Floreses have also been systematically excluded from public benefits that provide access to health care; owing to the parents’ ineligibility for Affordable Care Act insurance subsidies or for Medicaid, the Floreses have limited coverage options, and are buying insurance on the open market to help pay for a U.S. citizen’s cancer treatment. Only a handful of states have elected to use state funds to cover undocumented children. Only New York, Massachusetts, and California offer access to state-funded Medicaid for those enrolled in the Deferred Action for Childhood Arrivals program. The undocumented population is generally young, but people do get sick, and undocumented workers tend to be employed in jobs—food services, construction, farm labor—that expose them to a heightened risk of injury. Our patchwork of safety-net programs, federal and state exclusions, and expensive “emergency” provisions makes neither economic nor moral sense.

Nancy Berlinger
New York City

Nancy Berlinger is a research scholar at The Hastings Center and a co-director of the Undocumented Patients project. 

This letter was originally published as a letter in The New Yorker‘s August 24, 2015 Issue. Please click here to access the original letter online.