Uninsured and Uninformed: The Healthcare Crisis Facing H-2A Workers in Colorado

The H-2A visa program has had no legislative cap since the program has launched, and so when the number of agricultural workers are increasing rapidly (one in six agricultural workers are from the program), the topic of how to fund these workers while keeping costs low is an increasing debate in Congress. However the debate has mainly focused on wages, developing a gap in the conversation: healthcare. The results of Project Protect’s 2025 Healthcare Survey of agricultural workers across Colorado documenting the actual living experiences of those with the H-2A visa reveal a healthcare crisis that congressional debates have largely ignored. 

Project Protect’s 2025 Healthcare Survey found that H-2A workers in Colorado are significantly more likely to be uninsured than workers not in that program. Of the 65 H-2A workers included in the sample, 85.9% reported having no health insurance, compared to 60% of the 506 non-H-2A agricultural workers in the same survey. This gap is proven to be statistically significant (p < 0.0001). This field of work is very dangerous, and thus ensuring access to H-2A workers should be scrutinized and a topic of debate among members of Congress. According to KFF Health News, in agricultural work the rate of death is seven times the national average of other lines of work. Workers spend long hours outdoors exposed to extreme heat, operating heavy machinery, handling toxic chemicals, and working with large animals. Working under these conditions carries risk of injury, illness, or even death depending on the circumstances. H-2A workers come with temporary visas to fill essential roles in Colorado’s fields and farms, and health insurance is one of the most important factors for their wellbeing and ability to work consistently towards providing value to our state’s farmers. With no insurance, there is no safety net in case an injury happens on the job, and the hospital bill could be crippling. H-2A workers in this survey reported almost zero access to any form of coverage outside of employer-provided plans, which is drastically different compared to regular agricultural workers who have more access to government and private insurance options.

You might expect H-2A workers that come to the United States through a formal employer sponsorship process would be more likely to receive employer provided health insurance than any other agricultural worker. With Project Protect’s 2025 survey, one can see this is not the case. Only 9.2% of H-2A workers reported that their employers provide health insurance or pay for their healthcare, compared to 18.4% of non-H-2A workers, meaning H-2A workers are half as likely to have employer provided coverage or support despite coming through a program that requires employers to meet specific housing and wage standards. While this difference did not reach statistical significance (p = 0.076), the trend still raises questions about what protections the H-2A program provides to workers. The H-2A program requires employers to provide housing, transportation, and wages at or above a set minimum rate, but there is nothing requiring employers to provide health insurance to their workers. This gap in program requirements might explain why H-2A workers, who are tied to a single sponsoring employer, end up with lower rates of employer-provided coverage than workers who found their jobs independently. As Congress debates expanding the H-2A program and adjusting its wage requirements, the lack of healthcare mandates stands out as a critical failure in oversight.

In addition to gaps in health insurance coverage, according to Project Protect’s 2025 survey, most H-2A workers are unaware that they can access healthcare assistance programs when they need it. When asked whether they knew they could request financial assistance at hospitals, 74.6% of H-2A workers said they did not know those services were available, compared to just 36.3% of non H-2A agricultural workers. The 40% gap is highly statistically significant (p < 0.0001), meaning it is very unlikely to be the result of chance. When uninsured H-2A workers need hospital care for an injury or illness, they won’t know that they have the right to ask for reduced or waived costs. Financial assistance programs exist at hospitals across Colorado and the United States, but they only help people who know how to use them. The awareness gap in this survey suggests that H-2A workers are not receiving sufficient information about their rights and options when it comes to healthcare, which is a failure that compounds or enhances an already serious problem of low insurance coverage rates within this population of H-2A workers.

Project Protect’s 2025 Healthcare Survey’s findings paint a picture that H-2A workers are significantly more likely to be uninsured, less likely to receive support from their employer, and much less likely to know about financial assistance programs than their non H-2A counterparts. As congress debates the Farm Workforce Modernization Act of 2025 and other proposals to reshape the H-2A program, Project Protect asks why healthcare access is not a part of the conversation. The H-2A package comes with standards for wages, housing and transportation, so adding a basic healthcare coverage or even mandating informing workers of their right and available assistance programs would be a step in the right direction.

A 2025 peer-reviewed policy analysis published in the National Institutes of Health found that expanding Federally Qualified Health Centers and establishing Medicaid billing for community health workers were among the most feasible and impactful ways to improve health workers to improve healthcare access for farmworkers. Organizations like Project Protect and its Promotora Network are working to fill this gap through direct community outreach, but policy change is needed at the federal level to ensure that a program bringing hundreds of thousands of workers into the country each year to perform physically demanding jobs guarantees those workers can access healthcare when they need it.