Healthcare Barriers for Unaccompanied Children

by Olivia Knight, MAS
Olivia is a Case Manager in the Juntos para Jóvenes Project, where she connects immigrant youth in Montgomery County with social services.

Case Manager Olivia Knight (center) with intern Ed Santana (left) and Executive Director Rachel Rutter at a #KnowYourRights event in Norristown, PA, in the Fall of 2022.

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Over the past six months that I have worked at Project Libertad, I have witnessed no less than six instances of barriers to medical care experienced by my clients. In some cases, these barriers were among those common and familiar to the entire immigrant community: a few examples include financial limitations, lack of insurance, language struggles, and health literacy. But one barrier has stood out as uniquely troublesome for newcomer immigrant youth who are unaccompanied. The experience of being a minor without a legal caregiver trying to navigate a complex web of private health systems, nonprofit clinics, confusing confidentiality laws, and rules about who can bring a minor to the hospital makes it–at times–impossible for our clients to receive medical care. 

Olivia supports a client dealing with food insecurity.

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It is so important to the Pennsylvania government for children to receive healthcare that all citizen children who aren’t already on their parents’ insurance plans are eligible for Medical Assistance or the Children’s Health Insurance Program (CHIP). But the reality is much harsher for unaccompanied children. Not only can they not qualify for health insurance until they have a pending legal case; they also cannot present at a doctor’s office or the emergency room without an adult caregiver. Because unaccompanied children have, by definition, arrived in the United States without their parents, they are often placed with a family member or adult family friend. These caregivers are designated by the Office of Refugee Resettlement, but they have no legal standing with medical establishments. 

Olivia (left) presents at a student assembly regarding mental health resources.

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This inability of the medical system to incorporate unaccompanied children is the reason I have received phone calls from doctors’ offices asking me if my clients’ caregivers were really relatives or friends. It is the reason my client could not be seen for a serious medical issue without an accompanying parent. And it is the reason I was told I could be reported by emergency room staff last fall for bringing my client there. The New York Times recently reported on the increasing number of unaccompanied children working in dangerous roles in violation of child labor laws. If we are incorporating newcomer immigrant youth into the workplace, we need to figure out how to incorporate them into healthcare settings. The burden should not fall on the children themselves.