Nearly 100,000 immigrants living in the Kansas City area are naturalized residents, each needing a medical examination to gain U.S. citizenship. However, affordable options for these exams remain limited.
Priyanka Raeburn, who moved from New Delhi, India, to Kansas City in January 2017, had prepared herself for the lengthy immigration process. But she didn’t anticipate the extended wait for the required medical exam.
Raeburn had come to the U.S. for higher education, earning two master’s degrees and attending law school. But it wasn’t until this past year that she was able to complete the medical exam required by U.S. Citizenship and Immigration Services (USCIS).
The exam, which must be conducted by a USCIS-authorized doctor, includes a medical history review, physical exam, chest x-ray, and syphilis blood test. It also involves checks for various health issues, including conditions affecting the eyes, ears, throat, heart, and lungs.
In the Kansas City metro area, only 17 locations offer the exams, which are provided by civil surgeons — doctors specially authorized to conduct immigration medical exams. With a growing immigrant population, the demand for these services is high, leading to long waitlists.
Adding to the problem, these exams are not covered by most insurance plans. One provider quoted Raeburn $1,400 for the exam, a cost far beyond her budget. There are no regulations capping how much can be charged for these exams, leaving immigrants with little choice but to pay high prices.
Raeburn said, “Imagine if you have to support parents or children as well. This is just an extra cost on top of all the other immigration fees.”
However, she found a more affordable option at the KC CARE Health Center, a community clinic that offers primary care, dental, mental health, and women’s health services. KC CARE charges just $250 for the immigration medical exam.
Dr. Craig Dietz, chief medical officer at KC CARE, explained that the exams serve two main purposes: screening for communicable diseases and ensuring vaccine records are up to date. Additionally, they provide a way for immigrants to access broader healthcare services. “If people are coming here for immigration services, I’m not just doing the exam. I’m trying to get them into other healthcare services they need,” Dietz said.
Dietz estimates that KC CARE has performed exams for around 500 to 600 patients since launching its immigration clinic about a year ago. The clinic has seen patients from over 60 countries, and demand continues to rise. In one day last week, 38 people showed up for exams.
Some patients have traveled from as far as Nebraska and Iowa to use the clinic’s services.
A recent report from the U.S. Office of the Inspector General highlighted concerns with the immigration medical exam process, including insufficient vetting of physicians. In some cases, doctors with histories of patient abuse or criminal records were certified to perform the exams.
Dietz believes that better controls on vaccine costs could help make the exams more affordable for immigrants. Raeburn also called for a subsidy to ease the financial burden on those seeking citizenship. “Immigrants who are trying to start a new life often don’t know where to begin. It’s easy to take advantage of them,” she said.
Despite concerns about future changes to immigration policy, particularly with President-elect Donald Trump’s stance on immigration, Dietz expects demand for medical exams to remain high. “The number of people already here in need of services is so great, I don’t expect demand to drop off much,” he said. “In fact, some people might feel even more urgency to complete their paperwork, so I expect to be busier.”
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