Health Board Considers Cost Of Care For Migrant Farm Workers

01/18/13 7:34AM By John Dillon
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The board that oversees health care in Vermont is looking at health issues affecting the state's undocumented farm workers.

The Legislature asked the Green Mountain Care Board to estimate how much it would cost to include the undocumented migrant workers in a universal coverage plan.

The first thing the board learned at a meeting on Thursday is there just isn't much hard information on how many people need to be covered, or what that coverage will cost.

"There is no comprehensive data on the size and demographics of our undocumented immigrant population," said Mike Donofrio, the board's general counsel who's preparing a report for the Legislature.

Donofrio said the best estimates indicate that about 1,500 to 3,000 workers - mainly from Mexico - are employed on the state's dairy farms.

They're mostly younger men, with relatively few health issues. Most work long hours in dairy barns under sometimes dangerous conditions.

Depression and anxiety are commonly reported health problems, according to research cited by Donofrio.

"That becomes a real serious issue because folks are isolated not only from their families and their home countries, they're very isolated on the farm because of their limited access to transportation and because of the nature of the work," he said. "And so, a number of sources reported those types of issues arising out of that sense of isolation."

Donofrio said the fear of immigration enforcement is one of the biggest barriers to getting health care.  

Dr. Allan Ramsay, a physician on the Green Mountain Care Board, underscored that point by relating his own recent experience treating an undocumented farmworker. The man had dislocated his shoulder but didn't want to go to a hospital emergency room for treatment. After struggling to communicate in Spanish, Ramsay said he learned the source of the man's concerns. 

"I kind of realized there were two issues. One is he does not want anyone to know his status. And two is, he just felt like this was going to eat up everything he was going to send home to Mexico for the next year, by going to the emergency room," he said.

After an unsuccessful attempt to get the man's shoulder back in place, Ramsay finally convinced the worker to go to the hospital.

Similar stories were related by Brendan O'Neill of the immigrant rights group Migrant Justice. He read a testimonial from a farmworker named Javier Franco, who avoided needed care because he couldn't afford it.

"A few years ago I had to work outside in the middle of the winter for many days in a row. And then I got sick with what I thought was a common cough," O'Neill said, quoting Franco. "Since I do not have health insurance or any benefit I ignored the cough. When I finally could not take it anymore, I went to the hospital. Unfortunately the cough evolved into a chronic pulmonary illness called farmer's lung."

The Green Mountain Care Board is charged with designing a health care system to meet the needs of all Vermonters. O'Neill said migrant farmworkers clearly fall under the definition of all Vermonters.

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