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How the Affordable Care Act is Affecting Refugees and Asylees' Health Care

Jamyla Kay

Every year more than 50,000 refugees and asylees enter the United States, and hundreds resettle in Maryland. 

On today’s edition of The Checkup, we hear from refugees and service providers about the changes to refugees' healthcare and the unique health challenges that many face.

Prior to Jan. 1 of this year, as "qualified non-citizens" refugees, asylees and several other groups were eligible to apply for federal health programs like Medicaid and Refugee Medical Assistance (RMA), and state programs like Primary Adult Care (PAC.) But without dependents and failure to meet Medicaid's income requirements, many refugees and asylees were not eligible to receive Medicaid benefits, and their RMA expired within 8 months, leaving many refugees and asylees without the continuous, comprehensive care that many needed. 

As of Jan. 1 all who are "qualified non-citizens" are eligible for Medicaid and can purchase insurance on the state's health exchange, the Maryland Health Connection. 


Credit Jamyla Kay
Albour at the IRC in Baltimore.

First we hear from Alnour Adam, who is in his 40s. Alnour Adam is from Darfur, Sudan and arrived in the U.S. in 2011. Then we hear from Elhadi Adam (Alnour and Elhadi are not related) who is also from Darfur, Sudan. He arrived in the U.S. in April 2013. The two men describe some of their health challenges and Robert Sellke, Special Needs Care Coordinator for the International Rescue Committee in Baltimore, tells us how the men's health care has changed. In their interviews, we also hear the voice of Sawsan Al-Sayyab, an IRC caseworker who served as Alnour and Elhadi's interpreter for these interviews. When needed, she translated from Arabic to English.

Sheilah Kast also speaks to Chuck Milligan, Deputy Secretary of Health Care Financing, and Medicaid Director at the Maryland Department of Health and Mental Hygiene. 

Then, Robert Sellke and Lauren Goodsmith, project coordinator for the Intercultural Counseling Connection, join Sheilah Kast in the studio to describe some of the additional considerations and challenges that must be addressed while connecting refugees and asylees to primary and mental health services.

More from our guests

In March 2013, Sawsan Al-Sayyab was one of Maryland Morning's guests for a segment on International Women's Day. You can read more about the segment here and you can listen to the segment below. 

March 2013 segment on Maryland Morning.

Elhadi at the IRC in Baltimore.

Elhadi Adam is married and has two children, who are still in Sudan. He works two days a week despite his serious health challenges, which includes a previous battle with tuberculosis. He said he hopes to resolve his health issues in the future so he is able to work full-time and pursue higher education. 

An extended interview with Elhadi Adam.

Despite his health problems, Alnour Adam works at a lacrosse equipment manufacturer and attends Baltimore City Community College where he is studying English. When he came to the U.S. Adam said he knew "ABC" and that was about it. He credits BCCC for helping him improve his English, and he has aspirations to be a surgeon. 

An extended interview with Alnour Adam.

“Our series ‘The Checkup:  How Health Care Is Changing in Maryland’ is made possible by grants from CareFirst BlueCross BlueShield, the Baltimore Association of Health Underwriters, and HealthCare Access Maryland.” 


Credit Jamyla Kay
Sawsan Al-Sayyab and Robert Sellke.


Sheilah Kast is the host of On The Record, Monday-Friday, 9:30-10:00 am.
Jamyla Krempel is WYPR's digital content director and the executive producer of Wavelength: Baltimore's Public Radio Journey. She collaborates with reporters, program and podcast hosts to create content for WYPR’s online platforms.