YSPH Students’ Research Helps Expand Health Care For Undocumented Pregnant Women and Children

In the spring of 2021, Yale School of Public Health students Sreeja Kondeti, M.P.H. ’22, and Thomas Stovall, M.P.H. ’21, were interning in the Connecticut state legislature as part of Assistant Professor Shelley Geballe’s Health Policy Practicum course.

Their research into options for health care for undocumented immigrants helped support the enactment of a law expanding Connecticut’s HUSKY health insurance program to include far more undocumented women and children who met certain criteria. Prior to this, Connecticut’s coverage was limited to “emergency Medicaid,” which included only the childbirth (labor and delivery) costs of undocumented women.

“I wouldn’t call it a discovery, but I am proud of what we were able to do,” Kondeti said in a recent interview.

As part of Geballe’s Health Policy Practicum course, Kondeti was placed with Connecticut state Sen. Matthew Lesser (D-Middletown), the Senate co-chair of the General Assembly’s Insurance Committee, who requested a policy brief on ways to expand health care access for undocumented immigrants.

Kondeti’s research revealed that multiple states had adopted the federal “unborn child” option in CHIP (the Children’s Health Insurance Program), which permits states to consider a fetus a “targeted low-income child” for purposes of CHIP eligibility, resulting in pregnant women gaining access to prenatal and labor and delivery care regardless of their immigration status.

“I found that Connecticut was not among the growing number of states taking advantage of this [provision] to expand coverage,” Kondeti said. She further found that six states were providing state-funded coverage to their low-income undocumented children and youth.

While Kondeti was doing her research for Lesser, Stovall was drafting a policy brief on health outcomes and health care utilization among Connecticut’s undocumented immigrants as part of his internship with state Sen. Marilyn Moore (D-Bridgeport), Senate co-chair of the General Assembly’s Human Services Committee.

“I knew Sreeja was working on the interface between our health systems and the undocumented, but I did not know of the intricacies of her work before she sent me the actual brief,” Stovall recalled. “I was then able to use it as a great source of information about the barriers to care that undocumented immigrant families face.”

Geballe, J.D. ’76, M.P.H. ’95, said that Kondeti, Stovall and their preceptors were encouraged by the possibilities the students’ research identified as it clearly showed there were “multiple ways to expand eligibility that some other states had already enacted and which, in the case of undocumented pregnant women, was through an explicit federal option for coverage,” Geballe said.

Supported by the students’ research, Lesser introduced a bill to expand government-sponsored medical insurance to many income-eligible undocumented pregnant women and children in Connecticut as other states had done.

“I was there for the public hearings and the committee meetings and watched the bill progress up the ranks,” Kondeti said.

At the conclusion of the General Assembly Session, Geballe sent the class an email summarizing the legislature’s actions, which included the General Assembly’s June 8 favorable vote to expand HUSKY Health to uninsured, income-eligible pregnant women and children under age 9 regardless of their immigration status. The new law also requires Connecticut’s Office of Health Strategy to study the feasibility of offering health coverage to income-eligible undocumented children ages 9–18, with a report to key legislative committees by July 1, 2022.

“That’s when I realized I actually helped make a tangible difference,” Stovall said.

Public Act 21-176 was signed into law by Gov. Ned Lamont on July 12, 2021.

It was a moment Kondeti said she will never forget.

“This has been one of the most meaningful experiences of my life,” she said.