The COVID-19 pandemic has revealed many of the inequalities in our state, one of these being access to health care. I have experienced this first-hand as a pediatrician who has practiced in Rhode Island for 20 years. I’ve worked exclusively in the core cities in Rhode Island – in the underserved communities of Woonsocket and Central Falls -- the communities with the highest child poverty rates in the state.
After working in community health centers in these communities for many years, in February of 2020, I opened a private practice for children, specifically to provide a medical home and free medical care to the children of Central Falls, one of the communities hardest hit by the pandemic.
My practice provides free care to children because providing care for only half of a family’s children is unacceptable. I cannot just treat the children who were born in the United States, while others who are living in the shadows of our society are not receiving care due to their immigration status. I could not pretend that asking families to pay even a small fee of $20 per visit was fair, since that could be the difference between whether the family was going to eat that day or not.
When we send children to public school, we don’t send some for free and make others pay. When we feed children in school, we don’t say it’s free or reduced price for some low-income children, but other low-income children should pay. Health care shouldn’t be any different.
I have personally seen the impact of kids with delayed treatment of a ruptured appendix and severe untreated asthma because families were trying to avoid medical costs. I’ve seen a paralyzed child be hospitalized for four months because the family could not afford the preventive and specialty treatment needed and instead incurred thousands of dollars of medical debt. I have seen suicidal teens go untreated. I was deeply devastated when one teen I had known committed suicide a year after graduating from high school.
If COVID has taught us anything, it has taught us that we are all one community and the health of one person impacts the health of all. Kids go to school together. They play together. They eat together, regardless of their insurance status.
Rhode Island previously provided access to health coverage for undocumented children until 2008, when funding was removed. Let’s do the right thing and get Cover All Kids done this done this session, starting with it being included in the Governor’s 2023 budget. It’s time to restore health coverage for Rhode Island children regardless of immigration status so they can be healthy and successful in school and life.
Dr. Beata Nelken is a pediatrician in Central Falls, R.I.