Decolonizing the U.S. Health Care System: Undocumented and Disabled after ACA

Abstract

The Affordable Care Act (ACA) explicitly denies newly arrived documented and undocumented immigrants health insurance coverage, effectively making them the largest remaining uninsured segment of the U.S. population. Using mixed qualitative methods, our original research illustrates the health consequences experienced by uninsured, disabled undocumented immigrants as they navigate what they describe as an apartheid health care system. Critiquing the notion of immigrants as “public charges” or burdens on the system, our qualitative analysis focuses on Houston Health Action, a community-based organization led by and for undocumented, low-income disabled immigrants in Houston, Texas. Engaging a critical migration and critical disabilities studies framework, we use this valuable case to highlight contemporary contradictions in health care and immigration legislation and the embodied consequences of the intersecting oppressions of race, ability, immigration status, and health care access.