Policy Analysis to Strengthen Healthcare Access for Illinois Farmworkers.

Abstract

US farmworkers are among the most vulnerable members of the labor force, facing hazardous working conditions and limited healthcare access. This policy analysis examines ways to improve healthcare access for farmworkers in Illinois to reduce health disparities and enhance public health. To identify viable policy options, the analysis incorporated an environmental scan, expert consultations, and a comprehensive literature review to map the healthcare landscape, reveal service gaps, and incorporate stakeholder perspectives. These options were then evaluated using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework and Kingdon's model, which assess feasibility, public health impact, and alignment with current political conditions. Four key options emerged: increasing Medicaid access by reopening and uncapping the Health Benefits for Immigrant Adults and Seniors Programs, pursuing a Section 1332 State Innovation Waiver, establishing Medicaid billing for community health workers, and improving Medicaid reimbursement rates for Federally Qualified Health Centers (FQHCs). Enhancing FQHC reimbursement was identified as the most feasible and impactful approach, enabling FQHCs to expand capacity, retain staff, and open new centers in underserved areas. Nurses play a critical role in advocating for equitable healthcare access. This analysis highlights the need for targeted, sustainable policy interventions to advance health equity for farmworkers.