National Farmworker Awareness Week: Invisibility in Health Access

The goal of the Affordable Care Act (ACA) is to increase access to health care and health insurance for the country’s most vulnerable and underserved populations. Unfortunately, farmworkers and their families, perhaps one of the most vulnerable and underserved populations in the U.S., are arguably an invisible community who has seen few benefits from the ACA. For those eligible to enroll in health insurance through the Marketplace, the barriers are tremendous. The application is complicated, in-person assistance in rural areas is limited, and health insurance portability (the ability to use insurance across state lines) is almost non-existent. Migrant farmworkers who enroll in health insurance must either choose to keep their health insurance from their home state, where the providers are out-of-network and costs for seeking health care are high, or re-enroll in health insurance when they move. Due to the time-consuming and complicated Marketplace application and the limited 60-day window in which they can enroll (if it is outside of open enrollment), few migrant farmworkers choose to re-enroll each time they move.

The majority of farmworkers are ineligible to purchase health insurance in the Marketplace due to their immigration status. Undocumented individuals are completely excluded from the ACA. They are not allowed to purchase health insurance in the Marketplaces, even if they want to pay the full cost of health insurance coverage. Farmworkers with Deferred Action for Childhood Arrivals (DACA) status are also ineligible for Marketplace coverage because they are not considered lawfully present for the purposes of the ACA. With the employer mandate in effect, some farmworkers may be offered health insurance by their employer, but many find the costs of premiums to be unaffordable. Still others will not be offered insurance coverage because some large agricultural employers may be exempt from the mandate if they employ a largely seasonal workforce. There are efforts underway to pass legislation that would carve out even more exemptions for agricultural employers. 

We applaud the efforts of community health centers and others who have undertaken vast efforts to educate and enroll farmworkers in health insurance and connect farmworkers to health care. But we have a long way to go before farmworker communities will fully benefit from the Affordable Care Act. Farmworker Justice works with farmworker communities, health care providers, and federal officials to help them understand the benefits and challenges of the ACA for farmworkers and their families.