Dear IHN Community,
I am the son of immigrants.
My mother immigrated to the United States from Jamaica, and my father from the Commonwealth of Dominica. I was born in the United States, but my understanding of home, community, and belonging was shaped across many places.
As a child, I was blessed to live with my father in Senegal and Mali before returning to the United States, first to the urban neighborhoods of Baltimore and later to rural and suburban communities in Alabama. I eventually made my way to the Midwest to attend Washington University in St. Louis. My family’s story is neither unique nor should it be considered exceptional.
Those experiences taught me that the American story is shaped by many journeys, backgrounds, and communities – and that each can deepen our shared sense of belonging.
My first job as a physical therapist was at a rural hospital in Rome, Georgia, where I worked alongside immigrants and U.S.-born colleagues providing essential medical and rehabilitation services. Later, during my career at WashU Medicine, I had the privilege of helping recruit talented scientists, trainees, clinicians, and staff from around the world. Immigrants enrich our St. Louis community, generate new knowledge, care for our neighbors, train the next generation, and help advance health and medicine in our region and beyond.
Now, as President & CEO of the St. Louis Integrated Health Network, I have the privilege of working alongside a network of safety-net providers, many of whom come from nations around the world and dedicate their talents to caring for St. Louisans. That includes members of our own IHN team, whose work helps people (whether U.S.-born or foreign-born) maintain, regain, or obtain health coverage and, through it, access necessary clinical and social services. Through both lived and professional experience, I have come to understand not only the challenges immigrants face in the United States, but also their extraordinary promise and contributions.
A person’s worth to our community should never be measured by the letters behind their name, their professional title, or the institution where they work. Our communities are strengthened every day by immigrants who care for our children and elders, build businesses, conduct research, prepare food, teach students, provide health care, worship alongside us, and make St. Louis home.
Tomorrow, a significant change takes effect.
On October 1, provisions of H.R. 1 will substantially narrow federal Medicaid and CHIP eligibility for certain immigrants. With limited exceptions, this includes many refugees, asylees, parolees, and victims of trafficking unless they have another qualifying immigration status.
This distinction matters: these changes are not about undocumented immigrants gaining or losing full Medicaid coverage. They affect people who are lawfully present in this country, including people admitted through humanitarian pathways.
Here in St. Louis, this policy change is not theoretical. It will impact approximately 4,000 individuals in the St. Louis area.
IHN has been collecting stories from people who stand to lose their health insurance. They include:
- A family whose child is in the midst of cancer treatment;
- A father receiving care for a traumatic brain injury sustained while working alongside U.S. troops in Afghanistan;
- A mother diagnosed with breast cancer in August who will need continued treatment after losing Medicaid;
- A child with significant disabilities, who requires a breathing tube and ongoing medical care.
Imagine receiving one of those diagnoses and then learning that the health coverage helping you obtain treatment is disappearing.
These are our neighbors.
IHN and our partners are responding.
Our responsibility cannot end with describing the problem.
IHN is working with the U.S. Committee for Refugees and Immigrants (USCRI) Missouri through a Missouri Foundation for Health-supported initiative designed to bring health care organizations, immigrant- and refugee-serving organizations, community partners, and other stakeholders together to develop sustainable pathways to care. The work is intended to identify barriers, map available resources, strengthen referral pathways, and support organizational and systems-level changes that improve access to care for refugees and immigrants.
We are also continuing our partnership with Casa de Salud to strengthen and standardize pathways to care for immigrants across the St. Louis region. Our collaboration includes working with hospitals, Federally Qualified Health Centers, and other partners to improve referrals, charity-care processes, cultural competency, and coordination for immigrants and other patients who face barriers to care.
This work builds on IHN’s broader commitment to convene partners, educate frontline workers, and connect residents with navigation resources. The consequences of coverage loss extend beyond the individual: delayed care, avoidable hospital utilization, medical debt, and additional strain on health centers and hospitals ultimately affect the entire regional safety net.
Our history – and our future – call us to something greater.
The American story is complicated. We are a nation shaped by Indigenous peoples, descendants of enslaved people, immigrants, refugees, and generations of people seeking opportunity, safety, and belonging. Our nation’s story contains profound injustice, but it also carries an enduring aspiration toward becoming a more perfect union.
If these stories concern you, I encourage you to contact your elected representatives and share your perspective on the importance of protecting access to health care for lawfully present immigrants. We also welcome your support of IHN’s community outreach, navigation, and access-to-care efforts.
| SUPPORT IHN’S WORK • givebutter.com/st-louis-integrated-health-network |
When someone comes to us with cancer, we should see the person before the immigration category. When a child struggles to breathe, we should see the child before the paperwork. When a father who served alongside American troops needs rehabilitation, we should see his humanity before anything else.
At IHN, our work begins with a simple premise: the person in front of us deserves dignity, compassion, and an opportunity to be healthy.
Tomorrow, thousands of our neighbors will face a new barrier to that opportunity.
In moments like these, I am reminded of words attributed to Louis Pasteur:
“One does not ask of one who suffers: What is your country and what is your religion? One merely says: You suffer, this is enough for me.”
That sentiment captures something fundamental about why many of us entered health care and public service.
We will continue working alongside them.
With appreciation and in service,
Andwele Jolly, DPT, MBA, MHA
President & CEO
St. Louis Integrated Health Network