Member Spotlight: Tiffany Joseph Highlights Language Barriers in Healthcare on Capitol Hill

Senior Digital Communications Associate

In June, Professor Tiffany Joseph attended the SSN National Leadership Convening in Washington, D.C., where more than 150 participants gathered to bring SSN's mission to life. The convening provided a dynamic platform for SSN members and chapter leaders to connect, share strategies, and engage directly with policymakers, journalists, and civic leaders – showcasing the collective power of the network to inform public policy by connecting research with those in positions to act on it.

Following the convening, Joseph participated in a series of congressional meetings organized by SSN where she drew on her decade-long research into immigrant healthcare access and health policy, soon to be published in her forthcoming book, Not All In: Race, Immigration, and Health Care Exclusion in the Age of Obamacare. During these discussions, she highlighted the critical issue of language barriers in healthcare—an often-overlooked challenge that surfaced repeatedly in her research. SSN spoke with Joseph about the connections she’s begun to forge with lawmakers, the key findings she presented, and her plans to continue sharing her research with policymakers. The conversation has been edited for length and clarity

Q&A with Tiffany Joseph

What inspired you to want to set up congressional meetings at the SSN National Convening?

I really wanted the opportunity to be able to connect with legislators because, like many SSN members, my research is directly related to policy. I've been working on a research project over the last decade looking at the relationship between immigrant healthcare access and health policy. And because that research is now a book that's coming out, I'm in a position where I know the findings of the work, I can talk about the implications of it. When I received the email from Olivia Brochu, SSN’s Senior Policy Associate, asking about the opportunity to connect with lawmakers at the retreat, I thought this would be a great chance to try to get some practice talking about my work with policymakers in a non-academic way, highlight some of the important findings of my research, and start developing relationships with policymakers.

What key findings of your research were you hoping to highlight for legislators? 

So I think the biggest parts of what I wanted to bring up I wrote about in the brief. I feel like we hear so much in the media about issues around immigration, we hear about health care, and oftentimes we're missing a really important piece of that which is how people are able to communicate or understand what's happening to them in the healthcare system, either when they're engaging with their health care providers or just trying to sign up for coverage. A lot of times that stuff is really confusing, even for people whose primary language is English, and so I often think about the people that I interviewed whose primary language was not English and how they must be understanding and navigating the system under those constraints. I really found that in my research, the issue of language just kept coming up over and over and over again, and it's something that hasn't been fully addressed, or at least implemented within the policy landscape. These are things that policy hasn't quite adapted for, or really taken into account as explicitly that play a really big role in shaping people's ability to apply for coverage, but also, once they get that coverage, to then figure out where they can use that coverage in the healthcare system. 

How did you select the offices you visited, and how many did you meet with?

So I ended up visiting four offices, and three of those offices were people who are in my state delegation: Congresswoman Katherine Clark’s Office (D-Massachusetts, 5th), Senator Elizabeth Warren’s Office (D-Massachusetts), Congresswoman Ayanna Pressley’s Office (D-Massachusetts, 7th), and Senator Maggie Hassan’s Office (D-New Hampshire). 

I wanted to meet with people from the Massachusetts delegation primarily because it's where I live, it's where I work, it's where I've been doing research on the relationship between immigration and health policy for the last decade almost. I wanted to be able to speak with some of their staff about what I'm finding in my research because I think the Affordable Care Act (ACA) was really important in terms of its passage for extending access to coverage, but it wasn't perfect. It didn't extend access to everyone. Many immigrants are excluded on the basis of documentation status. You have people living in certain states in the country that did not expand Medicaid, so you still have citizens who don't have access to adequate healthcare under the ACA. So I really wanted to be able to speak with them about some of the findings of this research and highlight the language access piece, because again, I feel like it flies under the radar, but it's something in my research that just came up over and over again from my interviews with immigrants, with healthcare providers, with employees from immigrant and health advocacy organizations.

What was it like to take these meetings on Capitol Hill? 

It was a weird kind of a day to be doing the congressional meetings, just because it was the day that, in the Senate, there was a bill put forth around protecting access to contraceptive and reproductive care and then there were no Republicans who voted for it. I was going into each office and every time there was some news channel with the deliberations on what was happening on Capitol Hill. And so I'm sitting and thinking to myself, “This is really getting scary and real.” The fact that Roe v. Wade has already been overturned, and now you have lawmakers who don't even want families or people to have access to contraceptive care. I met with all Democrats, so clearly that wasn't an issue, but I was just thinking about the fact that this is what's happening in our country at this moment, and it just felt really surreal to be a woman and a woman of color on Capitol Hill walking back and forth to these meetings with lawmakers to talk about language access, when it just felt like more of our rights are kind of being stripped away bit by bit, or the attempt to do that. It was really bizarre and surreal. 

How did your congressional meetings go, and what stood out to you?

They went really well. This was my first time doing anything like this so I was very nervous. Olivia did an excellent job of preparing all of us. At the end of those preparations, I was still very nervous about how this would go because seeing those names on the sheet, the staff people in the offices I was meeting with, I thought, “Wow, these are heavy hitters.” I felt a sense of pride because I'm in Massachusetts, and these are the people that represent me, and I think they do really important work that I very much support. I had four meetings, and they were kind of spread out throughout the day. My first meeting was with the staff person for Congresswoman Clark, and this was someone who was familiar with SSN, so I didn't even have to do the spiel that we were trying to do and this person was just very receptive. I knew I only had 30 minutes, but we had a really great back and forth conversation, talking about language access, how that affects immigrant communities, but also citizens too, and thinking about ways in terms of policy recommendations to try to be able to address that. And so the policy recommendations that I mentioned were the ones that I wrote about in the policy brief around sort of enforcement of some key policy items that are already in the ACA, as well as just thinking about policies at the state level in Massachusetts.

Did the policy brief you prepared help in conveying your message during the meetings?

Absolutely, and it was nice to be able to have a document that I could actually leave with them that was related to the major points that I had spoken with them about in our meetings. I was really thankful that Olivia had reached out and recommended that we write a brief before these congressional meetings. I was glad that I had the time to do it, and that she provided feedback on it, before it went up on the SSN website. The brief served as a really good way for me, especially when I was nervous or before I went into meetings, to sort of refer back to and then also have something to leave with the staff people I met with.

What were your goals in having these meetings, and do you feel you were able to achieve them? 

I really saw this as a way to start these relationships. After the meeting I had gotten the cards from the staff people with their email addresses, and I reached out and thanked all of them for meeting with me and many of them replied back. Some of them followed me on LinkedIn. I let the staff people know, if there's anything I can do, when they're back in Boston or the Boston area and they're talking about these issues with their constituents, if that's something that I can sort of attend and be a part of or support in any way, or if they need any research, statistics or anything like that, I'm happy to provide that. And I had also mentioned that when my book comes out, that I would definitely be open to send copies to them, because I think the findings will be really helpful for thinking about how to not only improve healthcare access in our country, but also really think about the impacts of the overlap between policy for people. I also offered to provide testimony if any of these things come up for testimony. It seems like in this current policy context, there is not much room for bipartisan agreement to bring some of these reforms that I think are needed to be able to come to pass. So maybe come November, come January, we'll see if it’ll be in a better place for that.

What advice would you give to other scholars preparing for their first congressional meetings?

Definitely reach out to SSN, because I felt so well prepared that I was just able to go into my meetings and even though it was only 30 minutes, with the training and the guidance that Olivia provided for us, I felt that I could do it. So even though I was nervous about meeting the staff people and being in the offices of these lawmakers that I really admire and respect, I felt very comfortable being able to talk with them about my work and to do it in a way that was very succinct. I would say any guidance or advice that's given from SSN about preparing for those meetings, take it. Then just do your homework on the people that you're meeting with around those policy issues.

How did this experience shape your perspective on being a public scholar?

The SSN National Convening and the congressional meetings really lit a fire under me in terms of feeling like, as an academic, I really need to be doing more to talk to lawmakers and the public in general about why policy matters  and why the things that our lawmakers do that seem like they're very up here at this high level, they have implications for us in our everyday lives. And so I just think that's become really important for me in terms of talking with my students and also thinking about opportunities to write and place op-eds and things like that. I think academics, really at this moment, need to be doing a lot more of that and I can do better myself too. Being at the convening and going to those meetings really sort of drove that point home for me. 

 

Northeastern University

Dr. Joseph's research explores the micro-level consequences of public policy on individuals, immigrants’ health and healthcare access, comparative frameworks of race and migration in the Americas, and the experiences of faculty of color and women in academia. She is the author of Race on the Move: Brazilian Migrants and the Global Reconstruction of Race (Stanford University Press 2015) and her research has been published in various peer-reviewed journals and mainstream media such as Newsweek and The Atlantic.