SACRAMENTO BEE

November 23, 2006

Farm workers’ study in limbo

Aim was to improve health care for migrants.  But

administration won’t release the results.

By Michael Doyle

WASHINGTON - Migrant farm workers face life-and-death questions about elusive health care.

So far, however, the Bush administration is keeping potential answers close to the vest.

Four years ago, eager for solutions, Congress ordered a study of farm worker health care. Three years ago, the study was done. It has been buried ever since, caught in a bureaucracy working at a pace of its own.

“We have been kind of frustrated,” said Wenceslao Vasquez, a California health activist who heads the Bush administration’s National Advisory Council on Migrant Health. “If we had the study, we would have the basis for pointing out our concerns.”

The nation’s estimated 3 million migrant and seasonal farm workers are generally poor. Three out of four earn less than $10,000 a year. Few are insured. By some estimates, only about 5 percent are covered by employer-provided health insurance. Their work is dangerous. Thirteen percent of U.S. occupational deaths in the 1990s occurred in farming, though farm workers made up only 2 percent of the nation’s work force.

Congress picked up on the problem in 2002 when it passed a package of health-care amendments. The legislation includes a requirement that the Department of Health and Human Services conduct a solutions-oriented study of farm worker health care.

It seemed controversy-free, as lawmakers agreed that better health care would pay off.

Congress directed the Bush administration to consult widely and answer specific questions. The study was to examine the barriers to farm workers enrolling in Medicaid and the State Children’s Health Insurance Program. The barriers might include language, complicated applications or lack of outreach personnel. It was to examine lack of “portability” — when farm workers obtain health care in one state but not another. It was to evaluate different solutions.

The Centers for Medicare and Medicaid Services completed the study in 2003. Since then, researcher William Clark informed the migrant advisory council last January, the study has remained “in clearance.” This bureaucratic limbo means that the study can’t be made public, nor can the recommendations incite congressional debate.