Out of Sight, Out of Mind: The Implementation and Impact of the Affordable Care Act in U.S. Farmworker Communities

Abstract

Farmworkers are a unique population within rural communities and are often overlooked and undercounted. They face significant disparities in health and health care access compared with the general rural population. One goal of the Patient Protection and Affordable Care Act (ACA) is to increase access to health care and health insurance for the country's most vulnerable and underserved populations. Farmworkers' numerous barriers to health care and health insurance remain, despite the ACA's progress. Apart from anecdotal accounts, we lack the necessary data to assess the ACA's impact on farmworker communities. This commentary imparts information about farmworker enrollment in and barriers to accessing health insurance, collected through individual conversations, focus groups, interviews, and informal surveys. Based on identified challenges and limitations, we make policy recommendations to assess and improve the implementation and relevance of the ACA in farmworker communities.

Lessons Learned from Data Collection as Health Screening in Underserved Farmworker Communities

“…11 Health care providers who do see farmworkers often do not conduct occupational health histories, which could facilitate early diagnosis and treatment of work-related injuries and illnesses. 12 Furthermore, health care providers may be constrained by limited translation services and lack of cultural awareness.…”

Providing Health Information to Latino Farmworkers: The Case of the Affordable Care Act

“…When this study was conducted, the Affordable Care Act (ACA) was a major health program that could improve health care access for Latino farmworkers. Guild and colleagues 14 provided an overview of the issues surrounding the implementation and impact of the ACA for farmworkers. Although some Latino farmworkers were not eligible due to their immigration status, those with H-2A visas were eligible to apply for health insurance through the ACA.…”

Health Insurance Coverage for Farmworkers in California After the Introduction of the Affordable Care Act

“…However, the ACA did not provide coverage for undocumented workers through Medicaid or health insurance exchanges 14. Agricultural employers with over 50 full-time equivalent employees were required to offer insurance, but only to employees working at least 120 days/per year, thereby excluding seasonal employees 15,16. Hence, the ACA had a differential impact on agricultural workers compared with workers engaged in other occupations.…”