The Unfulfilled “Benefits” of the H-2A Visa Program

Project Protect’s 2024 Preventative Healthcare survey assessed the healthcare opportunities available to agriculture workers in Colorado, asking questions such as whether respondents had health insurance, and if so, what type, instances where health services were needed but could not be used, the kind of health concern, and payment types for health-related issues, to name a few. After examining specific data on visa status, it appears that those with H-2A visas have greater access to healthcare opportunities through their employer than those without, but this still does not account for 50% of the H-2A participant population. The structure of the H-2A program emphasizes a more direct employer-employee relationship that could potentially lead to healthcare benefits. However, this increased reliance also means that H-2A workers maintain less authority over their daily lives. Academic literature and one story from Esencial Colorado related to these findings raise the question of whether the minor benefits of this visa program are worth it to those actively performing the agricultural work.

 H-2A program allows farm owners to recruit non-domestic and non-immigrant workers, typically from Mexico, to work temporarily in agriculture on a visa, receiving certain benefits, such as provided housing and transportation to and from work, according to the official US federal legislative information page on H-2A visas, Congress.gov. Unfortunately, the U.S. Government Accountability Office (GAO) has documented widespread failures to comply with these requirements, and housing costs are now deducted from workers’ paycheck. 

Data from the survey suggests that those with H-2A visa status marked more actual answers regarding their health issues and use of health services, rather than responding with “None” for most of the health and medical experience-related questions. In contrast, a higher amount of responses corresponding to “None” came from non-H-2A agricultural workers, potentially communicating that those without visa status have a harder time accessing healthcare insurance, needs, or services, or that they are less willing to disclose information about their health and medical experiences than those with H-2A visa status. A closer look at Graph 1, which references respondents’ access to healthcare, reveals that while H-2A workers are more likely to have health insurance (40%) than those not on the program (~30%), over 50% of the H-2A population still lack health insurance. Of the H-2A workers with health insurance, the majority indicated their insurance was employer-paid, accounting for 35% of participants, which could correlate with the potential benefits associated with the program, such as the requirement that employers provide health services to H-2A workers injured while working. This data supports the notion that the employment relationship for H-2A participants does cause differences in healthcare coverage compared to non-H-2A workers because they work for larger employers and are documented individuals. Despite these findings, the large gap in Graph 1 within the H-2A workers’ responses regarding access to healthcare demonstrates that this access is relatively insignificant if most of the population still lacks health insurance. 

The effects of a majority of H-2A workers remaining uninsured are communicated in a story from Escencial Colorado that describes how a promotora, a person who provides health-related education and assistance to those in a community they’re familiar with, came in contact with an H-2A visa worker who arrived in the United States to work but quickly became hospitalized because of an illness and couldn’t afford his medical bills. The worker intended to return to Mexico soon and wished for help regarding these outstanding payments. Diane Mendez, the promotora, after calling the hospital, informed him that the hospital’s program only attended to cases from 90 days prior, meaning that because his hospitalization was five months ago, he couldn’t receive assistance with his medical payments. The man expressed concern about not being able to return to the United States to work if he could not receive help paying the hospital bills, and a more pressing issue: that if he did come back, problems would be awaiting him here in the United States that would significantly affect his ability to work (Escencial Colorado, 2021). While this is only one instance of an H-2A worker having healthcare concerns, it reveals a real response to worries about paying for health services that could affect the individual’s well-being, work opportunities, and potentially, their family’s prosperity. The high costs of participating in the H-2A program, such as being displaced from home and having a stricter employer-employee relationship, appear to outweigh the supposed benefits of the program when not every worker has actual access to them.

 The dangers of the H-2A program’s rigid structure are supported through academic literature, where an older source from 2000 discloses the exploitative nature of the H-2A program, affecting a worker’s capability to thrive. Cecilia Danger argues that “foreigners who legally come to the United States under the H-2A visa program are exploited even more than those who come illegally” and that they “give up considerable control over their lives,” potentially inhibiting their health opportunities. An article by Luckstead and Devadoss from 2019 advocates for the continuation of the H-2A visa program due to its ability to solve labor shortages, stating that a “better functioning H-2A program is considerably less expensive than immigration control policies”. This article, focusing more on the program’s assets for employers, implies that more H-2A workers would improve the United States’ agricultural economy but disregards issues such as the corrupt working conditions Danger discusses. Therefore, these observations can lead to dialogue concerning the H-2A visa program’s nuanced potential regarding healthcare options and the overall livelihoods of non-immigrant workers. 

Even though Danger’s article is now 26 years old, she relays alarming information about the harmful effects those working under an H-2A visa experience, influencing more than just their health and impeding their ability to work, similar to the H-2A worker’s concern about unpaid hospital bills blocking his return. Danger’s findings are supported by the 2024 GAO Report calling for more oversight and enforcement. This blog’s investigation urges readers to analyze the findings from the Project Protect survey deeply and with a critical eye: are the ramifications of the H-2A program worth the minor benefits of healthcare access when most workers never reap them?