Framing Deservingness in the United States: Unauthorized Immigrants and the Right to Health Care

By Professor Anahi Viladrich

In recent years, the United States (U.S.) has witnessed heated debates on immigrants’ rights to government-sponsored health coverage, particularly after the passage of the 2010 Patient Protection and Affordable Care Act (i.e., ACA or Health Reform; Public Law 111-152, 2010). ACA was aimed at providing accessible and affordable health care coverage to formerly uninsured populations. However, it ended up barring undocumented immigrants—about 12 million people—from any publicly subsidized health insurance. Given the American public’s heated rhetoric with respect to immigration, scholars have become increasingly interested in understanding the frames most often used by the media that argue for either the inclusion or exclusion of unauthorized immigrants in the U.S.

Frame analysis, a well-known conceptual tool among political theorists has become popular in the broader social sciences in recent years given its power to deconstruct and explain media images. In this article, we define frames as conceptual packages of information summarizing a topic and imbuing it with a particular moral weight and ideological direction. For example, terms such as “illegal immigration” or “amnesty” are not neutral as they imply that unauthorized immigrants are law-breakers and perpetrators of criminal acts. Given the ubiquitous presence of the media and its role in shaping attitudes towards immigration, it is key for researchers to understand the common frames (i.e., scripts, metaphors and representations) that are publicly constructed either against or in support of immigrants’ entitlement to health services.

In our analysis of immigration in the U.S. context, a country where health care is a commodity, we found that inclusion has traditionally been supported by special circumstances. Typically, the rights of non-citizens to government-sponsored health care have been backed as a way of avoiding unintended consequences (e.g., as in the case of pregnant women bearing American children, whose lives may be at risk, or immigrants who are carriers of infectious diseases and are deemed a danger for the general U.S. population). Furthermore, public opinion has usually favored particular immigrant groups such as the innocent victim, the effortful agent, the elderly, the young, the frail, and the disabled. More recently, the U.S. media has supported highly educated immigrants, particularly those who arrived to the U.S. as children (i.e. Dreamers). These individuals are not only presumed to be industrious and talented but also “innocent,” a frame based on the assumption that they were not brought to the U.S. of their own volition.

The frames summarized above can be conflated under the figure of the “deserving” immigrant, an overarching frame that is at odds with the notion of immigrants’ entitlement to health care as a fundamental human right. While the U.S. represents a radical case, where universal health coverage represents a market-based commodity that is available either to those deemed exceptional or those with the financial means to access it, the principle of access to affordable (or free) and safe health care is being challenged in many countries. In this context, understanding how immigrants’ representations are socially constructed and disseminated through media frames is essential towards overcoming stigmatization, discrimination and exclusion of vulnerable groups across diverse nation-states and political sceneries.

Anahi Viladrich, PhD
Professor
Sociology & Anthropology, Queens College
Sociology, The Graduate Center
Community Health and Social Sciences, CUNY School of Public Health
The City University of New York (CUNY)
www.anahi-viladrich.com

​