Legislation introduced today in the U.S. House of Representatives by Rep. Michelle Lujan Grisham (D-NM) would make a significant difference in increasing immigrants’ eligibility for health insurance coverage and access to health care—including sexual, reproductive and maternal health services. Other original cosponsors include leaders of the Congressional Asian Pacific American, Black and Hispanic Caucuses.
At present, a patchwork of policies put in place over the past two decades has hindered or blocked access altogether, putting affordable health care out of reach for many immigrants in the United States. The Health Equity and Access Under the Law (HEAL) for Immigrant Women and Families Act, would remove existing legal barriers to immigrants’ ability to obtain the health coverage they need. Specifically, the bill would:
- enable access to Medicaid and the Children’s Health Insurance Program (CHIP) for all lawfully present immigrants who are otherwise eligible, by eliminating the ban on enrollment until five years after an immigrant has established lawful status; and
- allow lawfully present young people (DREAMers) granted Deferred Action for Childhood Arrivals (DACA) status to participate fully in the Affordable Care Act, allowing them to buy coverage on the health insurance marketplaces, obtain subsidies designed to make coverage affordable, and access care through the Basic Health Program—and to enroll in Medicaid or CHIP if they are eligible.
Denying access to health coverage does not eliminate the need for health care. That’s why current restrictions are not only harmful, but also self-defeating, hindering immigrants’ ability to take responsibility for their own and their families’ health and economic well-being. Immigrant women are particularly affected by the existing restrictions, as they are disproportionately of reproductive age (15–44), poor or low-income, and lacking health insurance coverage. Among women of reproductive age, 45% of the 6.6 million noncitizen immigrants are uninsured, compared with 24% of naturalized citizen immigrants and 18% of U.S.-born women. Among reproductive-age women with incomes below the federal poverty line, fully 60% of noncitizen immigrant women lack health insurance.
Lack of health coverage constrains immigrant women's ability to obtain preventive sexual and reproductive health care services, ultimately denying them—and their families—the broader social and economic benefits associated with that care. Yet, regardless of their immigration status, immigrant women’s need for the full range of preventive and reproductive health care services is no different from that of U.S.-born women. Further, increasing access to needed preventive health care, including contraceptive counseling, services and supplies, could result in considerable savings for taxpayers. For example, while public expenditures on births resulting from unintended and teen pregnancies are significant, publicly subsidized coverage of the full range of contraceptive methods saves $5.68 for every $1 invested.
Thus, by enabling immigrants unencumbered access to private and public health coverage, the HEAL Immigrant Women and Families Act would improve their ability to obtain the full range of sexual and reproductive health and other preventive services. This, in turn, would help to reduce persistent health disparities among immigrant communities, and to advance the health and economic wellbeing of immigrant women, men and children, their communities, and the nation as a whole.
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