The Affordable Care Act will provide Marshallese families with access to health insurance through the Health Insurance Marketplace, said Laura Kellams, Northwest Arkansas director of Arkansas Advocates for Children and Families.
Marshallese individuals are eligible for tax-credit subsidies to purchase insurance in the insurance marketplace, according to a fact sheet prepared by the advocacy group. Marshallese residents, however, do not qualify for Medicaid services through their “lawfully present” immigration status.
“We as an organization are very happy that for the first time they are going to have some access to affordable health care,” Kellams said.“We think that even though they are not eligible for the private option, we think that there will be affordable option[s] for the families.”
Melisa Laelan is Marshallese and a certified Marshallese court interpreter. She said eligibility for insurance in the marketplace is a “huge break” for the Marshallese population.
“Most of us are able to acquire private insurance coverage through our employers,” Laelan said. “There is still a small portion of the population that lacks coverage. For example, little children that were brought here by extended family are not eligible to enroll under the employer. In addition, our older generation whom have retired out of the Marshall Islands are up the creek.”
The Marshallese are allowed to travel to the United States without visas or green cards. The U.S. and Marshallese governments made an agreement that Marshallese could travel to the country after the U.S. performed nuclear-bomb tests on two Marshallese atolls in the 1940s and 1950s.
“They are welcome here,but they can’t become citizens or vote here,” Kellams said.
Kellams said Northwest Arkansas has the largest population of Marshallese in the continental United States.
The U.S. Census Bureau reports that 3,985 “other Pacific Islanders” live in Arkansas. Marshallese migration to Northwest Arkansas started in the 1970s. Many came to the region for educational and work opportunities. Many sought jobs at poultry plants.
Sandy Hainline-Williams, nurse coordinator for the Marshallese Outreach Team in Springdale, said officials think the number of Marshallese living in the region could be much higher, as many as 6,000 to 10,000.
Hainline-Williams works with a team to provide medical attention to the Marshallese population in Northwest Arkansas. The team is located in the Joseph Bates Outreach Clinic in Springdale.
“In their education backgrounds, there is very little science,” Hainline-Williams said. “They live with pain, they anticipate that they should be in pain, and they don’t go to the doctor until it is really a crisis. One of our purposes for this clinic is so that they have a place to come if they need a doctor’s appointment.
Less than a quarter of the Marshallese population in the region most likely does not have insurance, Hainline-Williams said. She said there are many reasons for the lack of coverage. One is that many couples do not have legal marriages. This limits an employee from sharing insurance coverage with a spouse.
“They have traditional marriages,” Hainline-Williams said. “A legal marriage is a more expensive event. It’s not that they don’t want a legal marriage but that they can’t afford it.”
In Marshallese culture, a legal marriage is one documented by the Marshallese government, Hainline-Williams said. A traditional marriage is not.
Hainline-Williams said an expensive celebration is expected by family members when a couple is legally married.
Laelan said that some of her family members do not have insurance at the moment.
“At this time, they either have already enrolled in the ACA [Affordable Care Act] or in the process of doing so,” Laelan said.
Laelan said eligibility for the marketplace is seen as a “milestone” by the Marshallese.
“The only concern that I have been getting from most Marshall Islanders is the mandated penalty that applies to those who don’t enroll,” Laelan said.
Marshallese individuals are also subject to the penalties under the act for failure to enroll, the fact sheet states. The penalty in 2014 is $95 per person or 1 percent of yearly household income, whichever is higher.