Legislation reintroduced today in the U.S. House of Representatives by Rep. Michelle Lujan Grisham (D-NM) would significantly advance immigrants’ eligibility for health insurance coverage and access to health care—including sexual, reproductive and maternal health services.
Currently, a patchwork of policies put in place over the past two decades has put affordable health coverage and 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 and policy barriers to immigrants’ ability to obtain the health coverage they need. Specifically, the bill would:
- enable all lawfully present immigrants to access Medicaid and the Children’s Health Insurance Program (CHIP) if they are otherwise eligible, by eliminating the ban on enrollment that is currently in place for five years after an immigrant has established lawful status; and
- enable all lawfully present people granted deferred action—without exception—to participate fully in the Affordable Care Act, allowing them to buy coverage on the health insurance marketplaces and obtain subsidies designed to make coverage affordable, and to enroll in Medicaid or CHIP if they are eligible. This would include young people (DREAMers) granted relief under the Deferred Action for Childhood Arrivals (DACA) program and anyone granted relief under President Obama’s proposed Deferred Action for Parental Accountability (DAPA) program.
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; they are disproportionately poor or low-income, lacking health insurance coverage, and of reproductive age (15–44)—and therefore in need of sexual and reproductive health services.
Among women of reproductive age, 40% of the 6.6 million noncitizen immigrants are uninsured, compared with 18% of naturalized citizen immigrants and 15% of U.S.-born women (see chart). Among reproductive-age women with incomes below the federal poverty line (a group in which immigrant women are overrepresented), 53% of noncitizen immigrant women lack health insurance—nearly twice the proportion of U.S.-born women. Further, only 28% of poor noncitizen women of reproductive age have Medicaid coverage, compared with 46% of those born in the United States.
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 family planning services not only helps avoid myriad negative health outcomes, it also saves $7.09 for every $1 invested.
Thus, by enabling immigrants unencumbered access to private and public health coverage, the HEAL for 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.
For more information:
- The case for advancing access to health coverage and care for immigrant women and families
- Toward equity and access: removing legal barriers to health insurance coverage for immigrants
- Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010
- Beyond preventing unplanned pregnancy: the broader benefits of publicly funded family planning services