Exposure and exclusion: disenfranchised biological citizenship among the first-generation Korean Americans.

Based on fieldwork with a highly uninsured and underinsured Korean American population, this article maps how the current healthcare system in the United States disenfranchises those of marginal insurance status. The vulnerability of these disenfranchised biological citizens is multiplied through exposure to disproportional health risks compounded by exclusion from essential healthcare. The first-generation Korean Americans, who commonly work in small businesses, face the double burden of increased health risks from long, stress-laden work hours and lack of access to healthcare due to the prohibitive costs of health insurance for small business owners. Even as their health needs become critical, their insurance status and costly medical bills discourage them from visiting healthcare institutions, leaving Korean Americans outside the "political economy of hope" (Good, Cult Med Psychiatry 52:61-69, 2001). Through an ethnographic examination of the daily practice of doing-without-health among a marginalized sub-group in American society, this paper articulates how disenfranchised biological citizenship goes beyond creating institutional barriers to healthcare to shaping subjectivities of the disenfranchised.