Back to Results
Cover image of Not All In
Preorder
Cover image of Not All In
Share this Title:

Not All In

Race, Immigration, and Health Care Exclusion in the Age of Obamacare

Tiffany D. Joseph

Publication Date
Binding Type

Examines how health policy shifts fail to fully serve immigrant communities due to structural racism and anti-immigrant rhetoric and enforcement measures.

Despite progressive policy strides in health care reform, immigrant communities continue to experience stark disparities across the United States. In Not All In, Tiffany D. Joseph exposes the insidious contradiction of Massachusetts' advanced health care system and the exclusionary experiences of its immigrant communities.

Joseph illustrates how patients' race, ethnicity, and legal status determine their access to health coverage and care...

Examines how health policy shifts fail to fully serve immigrant communities due to structural racism and anti-immigrant rhetoric and enforcement measures.

Despite progressive policy strides in health care reform, immigrant communities continue to experience stark disparities across the United States. In Not All In, Tiffany D. Joseph exposes the insidious contradiction of Massachusetts' advanced health care system and the exclusionary experiences of its immigrant communities.

Joseph illustrates how patients' race, ethnicity, and legal status determine their access to health coverage and care services, revealing a disturbing paradox where policy advances and individual experiences drastically diverge. Examining Boston's Brazilian, Dominican, and Salvadoran communities, this book provides an exhaustive analysis spanning nearly a decade to highlight the profound impacts of the Affordable Care Act and subsequent policy shifts on these marginalized groups.

Not All In is a critical examination of the systemic barriers that perpetuate health care disparities. Joseph challenges readers to confront the uncomfortable truths about racialized legal status and its profound implications on health care access. This essential book illuminates the complexities of policy implementation and advocates for more inclusive reforms that genuinely cater to all. Urging policymakers, health care providers, and activists to rethink strategies that bridge the gap between legislation and life, this book reminds us that in the realm of health care, being progressive is not synonymous with inclusivity.

Reviews

Reviews

Not All In is revelatory. Drawing on in-depth interviews, Tiffany Joseph gives voice to individuals born abroad as they navigate the challenges of a health care system tilted toward the privileged. Throughout, Joseph proves a wise, sensitive, and humane guide through the labyrinths of health care and public policy. Not All In ought to be required reading for all Americans.

Exhaustively researched and thoughtfully argued, Not all In exposes how the Affordable Care Act is fraught with the same discrimination by documentation status and by ethnoracial origins as other public policies and has led to worse outcomes. This compelling book has implications beyond a single state or policy domain and reveals the fraying ideal of an immigrant America.

Not All In makes invaluable contributions to understanding the reverberating impacts of ACA, the most significant federal health care legislation since 1965. Joseph's carefully researched study provides new insights into how race, ethnicity, and documentation status intersect to create health disparities in Brazilian, Dominican and Salvadoran immigrant communities. Highly recommended!

Just when the term 'migrant crime' has been launched into our national consciousness, Tiffany Joseph provides a masterly response to help us make sense of the demonization of immigrants and the impact of racialization on access to health care. This is a must-read to grasp how a health care system built on structural racism collides with those of precarious legal status—often with deadly effect.

About

Book Details

Release Date
Publication Date
Status
Preorder
Trim Size
6
x
9
Pages
368
ISBN
9781421451114
Illustration Description
7 b&w illus.
Table of Contents

Tables and Figures
Acknowledgments
Lexicon
Introduction
1. Racialized Legal Status and Healthcare Exclusion in Boston
2. Included in Coverage but Excluded from Use (2012—2013)
3. The ACA Narrows, rather

Tables and Figures
Acknowledgments
Lexicon
Introduction
1. Racialized Legal Status and Healthcare Exclusion in Boston
2. Included in Coverage but Excluded from Use (2012—2013)
3. The ACA Narrows, rather than Widens, Healthcare Access (2015—2016)
4. Deterring Immigrants from Using Services under Trump (2019)
Conclusion
Appendix
Notes
Bibliography
Index

Author Bio
Featured Contributor

Tiffany D. Joseph, PhD

Tiffany D. Joseph is an associate professor of sociology and international affairs at Northeastern University. She is the author of Race on the Move: Brazilian Migrants and the Global Reconstruction of Race.