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Integrating Immigrants into the U.S. Health System

The Issue

There are about 7 million low- and middle-income documented immigrants in the United States lacking health insurance. With passage of the Affordable Care Act, these individuals stand to benefit by from the subsidized coverage options that will be offered in new health insurance exchanges. Documented immigrants also will become eligible for Medicaid coverage—which the law will make more broadly available—after they have been in the U.S. for more than five years.

What the Study Found

With more immigrants likely to gain coverage and seek medical services in coming years, the authors argue that physicians must develop competencies to provide culturally sensitive care to a more diverse patient population. This will require, among other steps, the recruitment of a culturally diverse workforce and the provision of language services to patients with limited English proficiency. In addition, providers will need to collect socioeconomic, epidemiological, and other data on immigrant patients for ongoing quality improvement efforts.


Noting that immigrants tend to use fewer health services than native-born individuals and are often less familiar with the health system, the authors suggest that physicians educate themselves about immigrants’ needs to better integrate this population into the health care system.

Publication Details



A. Vargas Bustamante and P. J. Van der Wees, "Integrating Immigrants into the U.S. Health System," American Medical Association Journal of Ethics, April 2012 14(4):318–23.