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Effective Messaging on Immigrants and Health Care Sonal Ambegaokar Health Policy Attorney National Immigration Law Center Health Action 2009 January 29,

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Presentation on theme: "Effective Messaging on Immigrants and Health Care Sonal Ambegaokar Health Policy Attorney National Immigration Law Center Health Action 2009 January 29,"— Presentation transcript:

1 Effective Messaging on Immigrants and Health Care Sonal Ambegaokar Health Policy Attorney National Immigration Law Center Health Action 2009 January 29, 2009

2 2 National Immigration Law Center Non-profit, non-partisan legal advocacy organization Policy analysis and advocacy; impact litigation; trainings; technical assistance; publications Issue Areas: immigration policy; workers rights; access to health care and other safety-net benefits for low-income immigrants www.nilc.org

3 3 Goals on Health Care Ensure public and private health coverage expansions in state and/or federal health reform and childrens coverage includes access for low-income immigrants, regardless of immigration status Incremental step: remove 5 year waiting period for lawfully residing immigrants in Medicaid/SCHIP (Immigrant Childrens Health Improvement Act (ICHIA)) Reduce/eliminate barriers to meaningful access to health care services for immigrants (e.g., health disparities, language access) Prevent immigrants from being used as a scapegoat in promoting health reform and other domestic policies

4 4 Challenges General misinformation about immigrants and health care Among advocates and policymakers Among liberal/progressives as well as conservatives Media coverage (mainstream and Web 2.0): currently one-sided Need for but uncertainty around comprehensive immigration reform Current climate makes immigrants fearful of accessing health care Political will

5 5 Changing the Debate Educating policymakers, the media, and the public regarding the facts about immigrants and health care Developing champions and spokespeople But, facts alone not enough With support from The David & Lucile Packard Foundation, invested in communication research/planning

6 6 Communication Goals Finding effective messages to: Promote INCLUSION of all immigrants in health reform and childrens coverage expansions Through the voices of all progressive allies Activate progressive/moderate voters to engage on this issue Counter immigration attacks with messages that are not harmful to immigrants and do not simply exclude immigrants Prevent immigrants from being used as a scapegoat or immigration as a wedge issue Having unified voice on the ultimate goal

7 Findings from NILC Focus Group Research

8 8 BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 8 Methods Fourteen focus groups: –Six in April 2008 Denver, Encino (N. Los Angeles), Pittsburgh Moderate-liberal White and Hispanic voters –Eight in July 2008 Denver, Columbus 4 among liberal-leaning, 4 among conservative-leaning White voters –Exclude those with extreme anti-immigrant views

9 9 BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S Context on Immigration Issues Overall Immigration illegal; legal immigrants viewed differently Concerns – not paying taxes, taking from social services, not learning English – are symbolic for violations of key values: Law and Order, Fairness, Patriotism, Responsibility Broad support for providing some way to legalize those already here 9

10 10 Immigrants and Health Care Attitudes motivated by similar values: –Compassion –Law-and-Order –Fairness and Responsibility Apply differently to different groups of immigrants BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 10

11 11 BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 11 Legal Immigrants and Health Care Little persuasion needed Legal adults should be eligible for government health care programs because they follow rules and pay taxes. 5 year waiting period for children is wrong because 5 years is too long to make a child wait, and their parents follow the rules.

12 12 Quotes: Legal immigrant children The five-year plan could be a lot longer of a wait than the course of a disease that this immigrant could get. So they could be dead before they got any benefits out of this. – Liberal man, Denver (phase 2) Because if theyre legal and theyre contributing, their parents are contributing to this society and everything, then I dont think there should be a five year waiting period for that any more than there would be for legal US citizens born and raised here who chose not to be employed and their children take advantage of the preschool stuff. – Conservative woman, Denver (phase 2) And thats what I wonder why theres a five year waiting period…if its because theyre making sure they dont come here for medical [care], but I think 5 years is way too long, especially for children. – Conservative woman, Denver (phase 2) BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 12

13 13 BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 13 Undocumented Adults and Health Care Impact of values: –A few see health care as a need and inclusion as the right thing to do (compassion) –Many see inclusion as rewarding illegal behavior (law and order) –Another large group focuses on contributing (responsibility and fairness)

14 14 BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 14 Undocumented Adults and Health Care Most successful message theme combines values & practicality: Society will be better off if we find a way for undocumented immigrants to contribute to costs and get the care they need to stay healthy

15 15 Undocumented Children and Health Care Many, especially in liberal and moderate groups support including children: –Children are innocent –Practical reasons support inclusion –Give children opportunity Most in conservative discussions oppose inclusion: –Childrens care is parents responsibility –Including children will attract more undocumented immigrants Pre-natal care is not helpful for persuasion BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 15

16 16 Quotes: Undocumented Children Well, I think it goes back to – we are talking [about] innocent children who, most of them, cannot help the fact that their parents are here illegally. It is not their fault that they are here illegally. I dont feel they should be punished not receiving medical care and being sick and then expecting everybody else because they are sick yet they dont qualify for health care because their parents are here illegally. A part of me says no, shouldnt provide it for them because we need to teach their parents that it is not okay to be here illegally. The other part of me says, but they are kids. They cant help it, and there is nothing they can do about it. – Conservative woman, Columbus (phase 2) Children didnt ask to be born. They get stuck with where they get stuck. They get in the situation they are in and they deserve to be healthy and strong. If they are not getting healthcare, they are not going to be healthy and they are not going to be strong. They are going to be throwaway kids. – Liberal woman, Columbus (phase 2) BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 16

17 17 Answering Pushback on Immigration in Health Care The special interests who do not want the health care system to be fixed are using these arguments about immigrants to block changes that could help make health care affordable for everyone. Immigrants arent stopping us from fixing health care – its insurance companies and pharmaceuticals and other people who are making lots of money by keeping things the way they are. We do need to address immigration in this country, but until we fix it, we cant let the immigration issue divert us from making sure that you, your neighbors, and everyone else gets quality, affordable health care. Everyone in America – including immigrants – should pay an amount they can afford for health care. BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 17

18 18 Recommendations – Overall 1) Focus on health care – specifically affordable health care for everyone 2) Connect with personal feelings and experiences – no one should have to live in fear BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 18

19 19 Recommendations – Overall 3) Address practical concerns – preventive care and everyone contributing 4) Assert that leaving people out will hurt all of us. BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 19

20 20 Message: All Immigrants Affordable health care for everyone in the U.S. is a necessity. This should include preventive care, because it will help people stay healthy and save us money down the road. We need a health care system where everyone contributes to the cost of medical care, and no one has to fear that one accident or illness will leave them unable to care for themselves or their families. In this system, everyone contributes, and everyone is secure in knowing that they can get health care; this needs to include all immigrants, legal or not. If we leave out millions of people living in our communities the system will not work and will affect all of us. We have to find a practical solution to our immigration system, but it is not realistic to deport the 12 million immigrants without legal status who are living and working in this country. Instead of excluding them, we will be better off if we make sure that they are contributing to the health care system. Everyone in the U.S., including all immigrants, should pay what they can afford and get the health care they need. BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 20

21 21 Recommendations - Children 1) Start with all children 2) Add information about children who are not covered 3) To persuade on undocumented immigrants, remind audience that children are in a situation they did not cause BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 21

22 22 Recommendations - Children 4) Emphasize the benefit of preventive care, including vaccinations 5) Focus on providing an opportunity BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 22

23 23 Messages - Children No child should be denied health care in the U.S. But right now, children who were brought here legally face a five-year waiting period before they are eligible for government health care programs [and children who were brought here as illegal immigrants are denied coverage]. Preventing children from getting the care they need is punishing them for a situation they didnt cause. All children should be able to get health care, so they have the opportunity to grow into healthy, productive citizens. Helping more children get health insurance will be better for all of us in many ways. Insured children are more likely to get preventive care such as vaccinations that can keep them healthy and give them the opportunity to grow into productive adults. All children should be able to get the care they need, and we should make that happen by [INSERT ASK]. BELDEN RUSSONELLO & STEWART R E S E A R C H A N D C O M M U N I C A T I O N S 23

24 24 Immigrant Health Messaging Overall Messages DoDont Start and end with the goal of health care for all people (or all children, etc). Start the conversation on immigrants need for health care. Emphasize that preventive care is cost-effective and helps people stay healthy. Claim that preventive care is cheap or will make people healthy. Answer attacks on immigration with practicality and values, and then return to health care for all. Return to health care without any real answer to attacks on immigration.

25 25 Immigrant Health Messaging Adults DoDont Focus on affordable care.Suggest free or government-provided health care. Emphasize that people using care will contribute. Focus on whats better for America – encouraging contribution and participation rather than division, isolation and impractical attempts at deportation. Make the conversation about whats best for undocumented immigrants.

26 26 Immigrant Health Messaging Children DoDont Inform about five-year waiting period. We shouldnt ask children to wait for health care and five years is a lifetime for a child. Expect any knowledge on this topic. Remind that children should not be held responsible for a situation they did not cause. They were brought here. Defend or blame their parents actions.

27 27 Sonal Ambegaokar NILC Health Policy Attorney ambegaokar@nilc.org www.nilc.org


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