New Jersey Sen. Cory Booker said he is planning to introduce legislation on Wednesday that would expand legal immigrants’ access to health care subsidy programs and allow unauthorized immigrants to buy health plans from federal insurance marketplaces.
The bill, known as the HEAL for Immigrant Women and Families Act, would permit legal immigrants to enroll in Medicaid and the Children’s Health Insurance Program (CHIP), provided that they meet the programs’ income requirements. Rep. Pramila Jayapal introduced the bill in the House in October 2019, but it would be the first time that the Senate would consider the legislation.
The bill isn’t likely to advance in a Republican-controlled Senate, where Senate Majority Leader Mitch McConnell has already rejected relief for unauthorized immigrants. But it’s the latest effort by Democrats to rectify inequalities in access to health care laid bare by the coronavirus pandemic.
Only a fraction of immigrants is eligible for Medicaid and CHIP: naturalized citizens, green card holders who have lived in the US for at least five years, immigrants who come to the US on humanitarian grounds (such as receiving asylum), members of the military and their families, and, in certain states, children and pregnant women with lawful immigration status. But many other categories of immigrants — including temporary visa holders and young immigrants who have been allowed to live and work in the US under the Deferred Action for Childhood Arrivals program — would become eligible under Booker’s bill.
“Covid-19 has shined a punishing light on the unjust health care inequities that exist for communities of color broadly, and immigrant communities in particular,” Booker told Vox. “While we should always be working to expand access to health care for everyone, the dire current situation highlights the urgency of addressing these gaps in health care coverage. Health care is a right, and it shouldn’t depend on immigration status. We’re never going to be able to slow and stop the spread of the virus be if we continue to deny entire communities access to testing, treatment, or care.”
The bill also contains provisions expanding health care options for unauthorized immigrants, who are often uninsured and have so far been largely left out of Congress’s coronavirus relief efforts. Booker’s bill would allow them to buy health insurance on the Affordable Care Act marketplace, from which they’re currently barred. It would also allow unauthorized immigrants to become eligible for health care subsidies if they have purchased such an insurance plan and meet other criteria, including minimum income requirements.
Immigrants are less likely to be insured and are more at risk in a pandemic
Immigrants are particularly vulnerable to the virus due to inadequate access to health care. Noncitizens are significantly more likely to be uninsured compared to US citizens, which may dissuade them from seeking medical care if they contract the virus. Among people under the age of 65, 23 percent of legal immigrants and 45 percent of unauthorized immigrants are uninsured compared to only 9 percent of citizens, according to the Kaiser Family Foundation.
They’re also reluctant to seek medical care during the pandemic. Many of them work in jobs that don’t offer paid sick leave, and the out-of-pocket costs for coronavirus treatment could leave them in financial ruin.
For immigrant women, almost half of whom are of childbearing age, the implications of being uninsured can be particularly harmful, “exacerbat[ing] their risk of negative sexual, reproductive, and maternal health outcomes, with lasting health and economic consequences,” Booker’s bill states.
Only some states have used their own funds to offer Medicaid to pregnant immigrant women with low incomes. In 15 states, all pregnant women are eligible for Medicaid regardless of their immigration status, and in 20 states, only those with green cards qualify.
Compounding matters is the chilling effect of the Trump administration’s hard-line immigration policies, including a rule that can penalize green card applicants for using Medicaid. That rule gives immigration officials much more leeway to turn away those applying to enter the US, extend their visa, or convert their temporary immigration status into a green card if it is deemed they would likely use public services now or in the future.
US Citizenship and Immigrant Services has said it won’t weigh Covid-19 treatment or preventive care, such as a vaccine if it is eventually developed, under the rule, even if those services are covered under Medicaid. But noncitizens say they’re still afraid to access care.
These factors pose a problem for America’s efforts to slow the spread of the virus, which has killed more than 90,000 people nationwide.
The CARES Act, a $2.2 trillion coronavirus relief bill signed in March, offers unauthorized immigrants limited access to free testing but otherwise no additional health benefits. The $3 trillion HEROES Act, the latest coronavirus relief bill that passed the House last week, attempts to rectify that gap in aid. The bill would allow immigrants without health care coverage to qualify for no-cost testing, treatment, and vaccines related to the coronavirus regardless of immigration status.
Offering these kinds of health care benefits is especially critical during the pandemic.
“In these difficult times, it is abundantly clear that our personal health and well-being are interdependent with our neighbors’, coworkers’, and society at large,” Kamal Essaheb, deputy director of the National Immigration Law Center, said in a statement. “Protecting the health and well-being of immigrants will ensure the health and well-being of us all.”