Thursday, April 23, 2015

Healthcare for Immigrant Women

By NAPAWF - Nearly two decades ago, politicians began passing harmful restrictions that put affordable health coverage out of reach for many immigrants who legally live and work in the United States. Today, even after passage of the Affordable Care Act (ACA), these overly complex and restrictive policies continue to deny access to healthcare for hardworking, taxpaying immigrant families.

The impact on our own community is telling. Nearly two-thirds of all Asian Americans and Pacific Islanders (AAPIs) are immigrants to this country and not only are we disproportionately likely to lack health coverage, AAPI women have higher rates of uninsurance than men. The over 100,000 AAPI DREAMers eligible for Deferred Action for Childhood Arrivals also continue to be locked out of the ACA exchanges. These restrictive policies are harmful to immigrant AAPI women and families, are costly and counterproductive, and undermine our shared values of fairness and equality of opportunity.

That's why our champion, Congresswoman Michelle Lujan Grisham, is reintroducing the Health Equity & Access under the Law (HEAL) for Immigrant Women & Families Act of 2015. 

The HEAL for Immigrant Women & Families Act removes political interference so immigrants can participate in the healthcare programs their tax dollars support. By restoring access to coverage and allowing immigrant families to receive the healthcare they need, this bill will create healthier communities and a stronger economy.

AAPI women need this policy change. They are less likely to have healthcare through their jobs and are more likely to be low-income and of reproductive age. Under existing policy, many lawfully residing women are forced to wait 5 years or more before they can see a doctor, while others are denied care altogether. Due to existing barriers to timely and culturally competent care, AAPI women already suffer from a number of health disparities, including some of the highest rates of cervical cancer in the country. For these women, 5 years could be the difference between life and death.

Access to the health care their tax dollars support

By Loretta Kane - Women’s health advocates, health care providers, and immigrants’ rights leaders applaud Congresswoman Michelle Lujan Grisham (NM-01) for introducing the “Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act of 2015.” This groundbreaking legislation restores access to affordable health coverage and care for immigrants authorized to live and work in the United States.

The growing list of supporters of the HEAL for Immigrant Women and Families Act of 2015 includes 120 national, state, and local organizations and associations.  

“The HEAL for Immigrant Women and Families Act of 2015 will guarantee that lawfully present immigrants who work hard and contribute to our economy will be treated fairly by the health care system they support when they pay taxes,” Rep. Lujan Grisham said. “I want to remove barriers that prevent access to health care programs like Medicaid and CHIP.”

Almost two decades ago, politicians began enacting harmful legal and policy restrictions that have put affordable health coverage out of reach for many immigrants. The HEAL for Immigrant Women and Families Act of 2015 removes political interference so immigrants are able to participate in the health care programs their tax dollars support. The bill:

●      Restores full-scope Medicaid and the Children’s Health Insurance Program (CHIP) to all lawfully present immigrants who are otherwise eligible. The bill removes the discriminatory legal barriers to health coverage for lawfully present immigrants imposed by the 1996 welfare law. It eliminates the restrictive and outdated list of “qualified” immigrants for Medicaid and CHIP eligibility, and eliminates the five-year waiting period.

●      Removes the unjustifiable exclusion of a subset of individuals granted deferred action from the Affordable Care Act (ACA), Medicaid, and CHIP. The bill would allow all deferred action recipients – including those with Deferred Action for Childhood Arrivals (DACA) and those who will benefit from expanded DACA and the new Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) – to obtain Medicaid or CHIP coverage if otherwise eligible and to purchase qualified health plans in the Marketplace, obtain premium tax credits and cost-sharing reductions, and enroll in the Basic Health Program.

●      Reinstates Medicaid eligibility for COFA migrants, or citizens of the Republic of the Marshall Islands, Federated States of Micronesia, and the Republic of Palau, under the Compacts of Free Association (COFA), who were inadvertently barred from the Medicaid program by the 1996 welfare law.

The legal and policy barriers to affordable health coverage imposed on immigrants disproportionately harm women by erecting persistent barriers to affordable health care and by contributing to needlessly high rates of health care uninsurance. The numbers speak for themselves. Among women of reproductive age, 40 percent of the 6.6 million noncitizen immigrants are uninsured, compared with 18 percent of naturalized citizen immigrants and 15 percent of U.S.-born women. It is even worse for reproductive-age women living in poverty, with over half of noncitizen immigrant women lacking health insurance — nearly twice the proportion of U.S.-born women. The HEAL for Immigrant Women and Families Act of 2015 would go a long way toward addressing these and other persistent inequities.

“Immigrant women make tremendous contributions to our communities, economy, and nation as a whole. Yet current federal immigration and health care policies fail to acknowledge the contributions and address the health care needs of immigrant women and families. The result is that millions of immigrant women suffer from preventable diseases, have no health care provider, and are hindered in their ability to fully contribute to their families and communities. It’s only fair and common-sense to remove political interference so immigrant women and families can participate in the health care programs their tax dollars support,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health (NLIRH). “Good health care ensures women have the opportunity to realize their full potential, care for their families, and make their own decisions about their future. That’s good for all of us.”

"Immigrant women are the backbones of their families and communities and yet they are disproportionately harmed by the current barriers to affordable health coverage. Asian American and Pacific Islanders already suffer from high rates of uninsurance and preventable disease. Our families should not be forced by politicians to wait years for the health care we need. This legislation is an opportunity for us to lift those barriers to coverage and ensure that immigrant women and their families are able to thrive. We applaud Congresswoman Lujan Grisham for her leadership," said Miriam Yeung, executive director of the National Asian Pacific American Women’s Forum.

“We applaud Congresswoman Lujan Grisham for her leadership in reintroducing this critical bill. Barriers to health care take a toll on the health of immigrant women and widen existing health disparities. Health coverage is crucial for a range of sexual and reproductive health care, including prenatal visits, contraceptives, sexually transmitted infection screenings, breast-feeding support, and routine gynecological care. As physicians who take care of immigrant women and families every day, we look forward to working with Congress and our organizational partners to see that it is enacted,” said Physicians for Reproductive Health Board Chair Dr. Nancy L. Stanwood, MD, MPH.          

“The health of our families is so often overlooked in the immigration discussion, when it should be a major focus,” said Kathy Ko Chin, APIAHF president and CEO. “The HEAL for Immigrant Women and Families Act does just that, by allowing immigrant women and their families to access the care they need and that their tax dollars support. Our country will be stronger and more successful when all residents have access to health care.”

“We are proud that our own Congresswoman Lujan Grisham understands that improving access to health care for our immigrant communities benefits us all,” said Tannia Esparza, executive director at Young Women United (YWU). “As a border state with diverse immigrant diaspora, we know eliminating barriers to care will have a real impact on the lives of immigrant women and families throughout New Mexico and across the country.”

“Planned Parenthood’s mission is making sure all women — regardless of income, insurance coverage, or immigration status — receive the health care they need to lead healthy and productive lives,” said Cecile Richards, president of Planned Parenthood Federation of America. “We thank Rep. Michelle Lujan Grisham for leading this effort and urge Congress to pass this legislation which will ensure immigrant women and their families have equitable access to reproductive health care, such as birth control and cancer screenings – without barriers getting in the way. It’s good policy – and it’s the right thing to do.”

“It is time that federal policymakers do right by our country and our communities by extending access to affordable, quality health care to everyone living and working in the U.S., regardless of their socioeconomic or immigration status. The Health Equity and Access Under the Law (HEAL) for Immigrant Women and Families Act of 2015 would bring our country one step closer to achieving equity in access to health care. We look forward to its consideration in Congress,” said Marielena Hincapié, executive director of the National Immigration Law Center (NILC).

"Limiting access to healthcare has a profoundly negative impact, especially for young people.  Removing unnecessary barriers that delay accessing health care or make it unaffordable is critical in advancing the health and well-being of young people, women and communities. Young people especially deserve access to the full range of health care services, not policies that deny access to basic services they need to lead healthy lives,” said Debra Hauser, president of Advocates for Youth.

“Everyone deserves access to health care, no matter your immigration status,” said Elizabeth G. Taylor, executive director of the National Health Law Program (NHeLP). “This is good legislation that removes barriers that currently prevent immigrant women and families from accessing the health care they need.”

“Continuing to deny immigrant women and men access to affordable, high-quality health care, including family planning services, contributes to adverse sexual health outcomes, such as unintended pregnancy and STDs, and puts undue strain on the nation's health and economy," said Clare Coleman, president & CEO of the National Family Planning and Reproductive Health Association (NFPRHA). "Given the significant unmet family planning and sexual health care needs among immigrant women, the HEAL for Immigrant Women and Families Act is a critical step toward improving access to care for immigrant families, which in turn will help alleviate health disparities in communities across the country." 

“The National Council of Jewish Women firmly believes it is a moral imperative to ensure everyone can access the health care they need, without jeopardizing their economic security or other basic needs. For too long, discriminatory bans have unjustly denied individuals and families access to health programs which their tax dollars support, simply based on their immigration status. These policies have fallen hardest on immigrant women, pushing critical, life-saving preventive care and other reproductive health services out of reach — hurting her health and economic security, and that of her family. The HEAL for Immigrant Women and Families Act takes important steps to lift these harmful barriers to health care, moving us closer to fulfilling our nation’s promise of ‘justice for all,’” said Nancy K. Kaufman, CEO of the National Council of Jewish Women.

“Health care is a human right for every woman, no matter her immigration status,” said Nancy Northup, president and CEO at the Center for Reproductive Rights.  “We commend Congresswoman Lujan Grisham for once again taking bold steps and introducing this critical legislation to ensure women, their families, and their communities are healthy and free of discrimination.”


The Florida House of Representatives passed a measure which would force a woman to wait 24 hours before seeking safe and legal abortion and make two separate trips to her health provider before she is able to receive safe, legal abortion care. 

“Women are more than capable of making thoughtful decisions about their health, pregnancies, and families, and the last thing they need is interference from politicians who presume they know better,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “In a region where neighboring states have been clamoring to erect as many barriers to safe and legal abortion as possible, Florida has long stood out by protecting women’s right to essential reproductive health care. We urge the Florida Senate to honor that history and reject this demeaning bill."

"This bill would severely restrict a woman’s access to safe and legal abortion in Florida by requiring someone seeking abortion services to make multiple, medically unnecessary appointments,” said Jessica González-Rojas, Executive Director at the National Latina Institute for Reproductive Health.  “The forced delay would create needless and burdensome logistical and financial barriers that would negatively impact Latina health and well-being in the state of Florida, as well as placing the constitutionally-protected right to legal abortion further out of reach for many. Furthermore, these policies would have a disproportionately negative impact on Latinas, immigrant women, young women, and women of color across the state, who already struggle to get the care they need."

Waiting periods can create a variety of burdens on a woman needing to access abortion—from increasing shame to requiring additional trips to the clinic, which means additional travel time, transportation costs, child care, and time off work.  Women of color, low-income women, rural women, and women in abusive relationships already face challenges when needing to access health care, and waiting periods only increase these barriers.   Additionally, extending the waiting period can lead a woman to delay the abortion to later into the pregnancy, which can increase the risks of the otherwise extremely safe procedure.

In a region devastated by similarly underhanded restrictions, Florida has long served as a safe haven for women from neighboring states seeking safe and legal abortion services.  From clinic shutdown laws--which have closed clinics in Texas and threaten to shutter abortion providers in Louisiana, Oklahoma, Mississippi, and Alabama—to outright bans on abortion, women in the South often face innumerable hurdles when trying to access their constitutional right to safe and legal abortion services.  Legislators’ time and effort would be better spent on increasing the number of policies that are known to support women and children rather than enacting abortion restrictions that will not only harm Florida women, but also wreak additional havoc in a region already decimated by similarly underhanded laws.

Harmful restrictions like these further underscore the need for the federal Women's Health Protection Act (S. 217/HR. 448)—a bill that would prohibit states like Florida from imposing restrictions on reproductive health care providers that apply to no similar medical care, interfere with women’s personal decision making, and block access to safe and legal abortion services.


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