Letter Concerning Migrant Workers' Healthcare

Dear Mr. Rodney Davis:

On behalf of the American Association of Colleges of Nursing (AACN), which represents the nation’s nursing schools with baccalaureate and graduate programs, I am writing to address concerns regarding healthcare accessibility for migrant farmworkers. According to the United Nations (1990), migrant farmworkers are considered to be those individuals who have migrated from their place of birth to another county in order to find full-time or seasonal farm work employment. Migrant farmworkers account for a significant percentage of the agricultural workforce in the United States. In fact, the National Center for Farmworker Health (NCFH, 2013a) found that more than 3 million migrant farmworkers are currently living in the United States. And yet, only 15% of legal migrant workers are currently insured. Furthermore, that percentage does not account for the substantial number of migrant workers who have entered the country illegally, making the number of uninsured reported significantly underestimated – and the actual percentage significantly higher.

Agricultural and economic development in the United States has been vastly aided by the labor of these migrant farmworkers for more than 150 years, and yet, the health and well being of this vital sector has been largely ignored and unaddressed. The growing significance of migrant farmworkers, to both local and national American economy, was recognized with the passage of the Immigration and Nationality Act of 1917 (NCFH, 2013b). This act allowed thousands of Mexican migrant workers to legally import into the country for agricultural labor (NCFH, 2013b). However, the healthcare needs of these individuals were not considered until the 1950s and 1960s, when public health workers finally began to recognize and advocate for their needs.

Since then, legislation regarding migrant farmworkers’ healthcare needs has progressed and continues to progress, at both the state and federal level. However, the significant amount of the uninsured evidence the need for continued legislative reform. The Affordable Care Act of 2012 is expected to advance the unmet healthcare needs of migrant farmworkers by expanding Medicaid eligibility for low-income families (Appeby, 2013). This expansion allows more than 50% of currently uninsured migrant farmworker families to qualify for healthcare coverage (Appeby, 2013). While this law greatly expands the former Medicaid eligibility guidelines, which precluded more than 85% of legal migrant farmworkers in the past to be insured, the law fails to meet the needs of the remaining 50% of migrant workers that will remain uninsured (Rosenbaum & Shin, 2005).

It is imperative that legislation regarding migrant farmworker healthcare needs continue to evolve. The current uninsured status of these workers has the potential for much illness and death since many of these workers are routinely subjected to pesticides, poor living conditions, poor health and poor diet. Without access to healthcare, workers are unable to find medical recourse for their ailments, which additionally, has the potential to drastically affect both the American and global economy – if agricultural labor declines, agricultural revue declines. This potential loss of revenue could prospectively be more costly than ensuring the workers and giving them affordable access to healthcare.

We can all be drastically impacted by the possibilities set forth above, and thus, we all are responsible for rectification. As a healthcare organization, we find ourselves responsible to advocate for this ignored and overlooked labor sector of our American economy. We hope that as legislatures, you will find yourselves to be responsible for listening to our pleas, recognizing their importance, and finally, reforming the legislation and addressing this potentially compounding issue.

Thank you for your attention to these concerns regarding healthcare access for migrant farmworkers.

Sincerely,

Name

President