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Unequal CoverageThe Experience of Health Care Reform in the United States$
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Jessica M. Mulligan and Heide Castañeda

Print publication date: 2017

Print ISBN-13: 9781479897001

Published to NYU Press Scholarship Online: September 2018

DOI: 10.18574/nyu/9781479897001.001.0001

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PRINTED FROM NYU Press SCHOLARSHIP ONLINE (www.nyu.universitypressscholarship.com). (c) Copyright University of NYU Press Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in NYSO for personal use.date: 20 September 2021

Stratified Access

Stratified Access

Seeking Dialysis Care in the Borderlands

(p.59) 2 Stratified Access
Unequal Coverage

Milena Andrea Melo

NYU Press

Milena Andrea Melo’s chapter examines the impact of the lack of health insurance coverage for low-income, undocumented immigrants who required regular dialysis to stay alive. Undocumented immigrants are deemed undeserving of most publicly funded health care services by virtue of their “illegal” status. Those with chronic, debilitating illness struggled to navigate public and private health care institutions as indigent patients in order to locate life-saving but substandard treatment. Since they were uninsured, irregular and costly dialysis treatments in hospital emergency rooms, paid by Emergency Medicaid, was their only option. The chapter demonstrates that the health system itself exacerbated health risks for dialysis patients by requiring that they come close to death before emergency services were offered. This chapter raises questions concerning belonging, deservingness of care, and American notions of human rights in cases where those with nothing more than “bare life” are excluded.

Keywords:   Emergency Medicaid, bare life, dialysis, undocumented immigrants, undeserving, belonging, human rights

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