immigrants and reproductive justice lillian m. hewko law students for reproductive justice fellow,...
TRANSCRIPT
Immigrants and Reproductive Justice
Lillian M. HewkoLaw Students for Reproductive
Justice Fellow, NHWN
• 30 Regional Coordinators (RC’s) in 26 states and District of Columbia
• National policy analysis, regulatory comments and advocacy, develop and share model state marketplace policies.
• We will cover: – Intros
• Reproductive (In)justice (activity)
– Immigrants and Health Coverage
–Barriers to Immigrant Women’s Health
–RJ Responses
Intro
Question: Where are your ancestors from?
Intro Activity
Values Activity-3 minPair share-2 minutes each
Immigration Values Activity
Values Activity-3 min: Strongly Agree (SA), Agree (A), Disagree (D), Strongly Disagree (SD)1. People should be able to move across borders in order to live or work
without limitations.
2. The government should provide public benefits, such as basic health care coverage to all people within its borders who do not have the ability to pay for such coverage, regardless of citizenship or residency.
3. Criminalizing individuals will help deter them from coming to the United States.
4. Immigrants come to the US because they would rather live in the United States.
5. The U.S. should be able to rely on immigrants to sustain the labor needs of our nation’s economy.
Immigrants in the U.S.
• 40.3 million foreign born (13% of total population)– 18.1 are naturalized
citizens (45% of immigrants)
– comprise about 17% of labor force
• 24.3% of children and 30.5% of low-income children have an immigrant parent
• 87% of children of immigrants are US Citizens
Immigrants & Health Care Needs
• More Likely to Be Uninsured– 46% of non-citizens are
uninsured, compared to 15% or U.S. Born citizens
– 45-55% of low-income immigrant children in the US are uninsured (but citizens make up bulk of the uninsured)
• Use Less Health Care– Immigrants use less health care– Per capita, immigrant use of
health services costs less than half the cost for average citizen
Who’s Eligible for Care?
Naturalized Citizens and“Qualified Immigrants”
– Includes LPRs, refugees, asylees, parolees, Cuban/Haitian entrants, certain domestic violence and trafficking survivors
– If entered after 1996, must have held “qualified” status for 5 years +
Additional Coverage for Immigrant Women & Children
• 30+ states provide health coverage to additional immigrants through federal option (CHIPRA) to cover – Lawfully residing children and
pregnant women regardless of entry, or
– prenatal care to women regardless of status using CHIP funds
• 15 states use state money to cover gaps for lawfully residing immigrants
WA
OR
CA
NV
ID
MT
WY
COUT
NMAZ
TX
OK
KS
NE
SD
ND
MNWI
IL
IA
MO
AR
LA
AL
TN
MI
PA
NY
VT
GA
FL
MS
KY
SC
NC
MD DCIN
DE
CA
OH
WV
NJCT
MA
ME
RI
VA
NHMI
Health Coverage for Immigrant Children | January 2014
KEY
Medicaid/CHIP for lawfully residing children, regardless of date of entry
Medical coverage for children, regardless of immigration status
Medical coverage for lawfully residing children (statewide), and for children regardless of immigration status in some counties
Alaska
Hawaii
Health Coverage for Pregnant Women
• 14 states provide Medicaid for pregnant lawfully residing immigrants regardless of entry
• 18 provide prenatal care to women regardless of status using chip funds
• Only 5 provide for children regardless of immigration status
WA
OR
CA
NV
ID
MT
WY
COUT
NMAZ
TX
OK
KS
NE
SD
ND
MNWI
IL
IA
MO
AR
LA
AL
TN
MI
PA
NY
VT
GA
FL
MS
KY
SC
NC
MD DCIN
DE
CA
OH
WV
NJCT
MA
ME
RI
VA
NHMI
Health Coverage for Pregnant Women | February 2014
KEY
Medicaid for lawfully residing pregnant women, regardless of date of entry
CHIP or other medical coverage for pregnant women, regardless of immigration status
Alaska
Hawaii
Barriers to Immigrant Women’s Health Care
Locked Out: No Access
• Undocumented Immigrants, temporary visa holders, DACA youth are:– Restricted from buying
health insurance on the marketplace
– Not eligible for tax subsidies
– Few exceptions for emergencies (e.g. pregnancy)
Fenced In & Locked Out: Restrictions on Low-Income Lawfully Present Immigrants
• 5 year Bar: lawfully present immigrants who entered the US after 1995 must have held “qualified” status for at least 5 years before they can receive Medicaid and CHIP
• Limited Federal Coverage: can purchase via Exchange, eligible for tax credits & cost-sharing subsidies
Contradiction: Keep Out but Help Wanted
• Immigrants work hard, pay taxes and contribute to our communities and the U.S. economy
• Historical Shifts– 1993 Border Security– 1994 North American
Free Trade Agreement
Immigrant Women & 1996 Welfare “Reform”
Immigrants and U.S. Economy
Reproductive Injustice
• Separation of families
• Lack of access to sexual, reproductive and maternal services
• Exposure and lack of resources for physical and sexual violence
Perfect Recipe for Reproductive Injustice: Crystal’s Story
No Public Funding for Abortion Services
Abortion Access• Some states allow Medicaid
eligible women access to state dollars for to obtain abortion services
• Citizenship requirements means no state abortion funding for undocumented or individual under 5 year bar
Repro Justice Legislative Responses
Federal ResponsesHealth Equity & Access under the Law (HEAL) for Immigrant Women & Families Act of 2014 (H.R. 4240)Sponsored by Representative Lujan Grisham (NM-01)
Seeks to remove harmful restrictions for lawfully present immigrants
Restores access to coverage and allows lawfully present immigrants to receive health care
HEAL Act Section by Section
Unique Repro Rights and Immigration Bill
• Section 3—Removes Barriers to Health Coverage for Lawfully Present individuals– Removes outdated and restrictive list of
“qualified immigrants”– These individuals would be able to access
coverage through Medicaid or CHIP
• Section 4—Removes Barriers to Health Coverage for Individuals Granted Deferred Action for Childhood Arrivals (DACA) program– These individuals would be able to access
coverage through Medicaid or CHIP– Can also purchase on their own coverage
the exchange, and get tax subsidy and cost-sharing benefits
State Responses to Attacks on Immigrant Health Coverage
Lifting Restrictions on ALL Immigrant Access to Health Care• CA Health Care for All Act (SB 1005)
– Will expand health coverage to individuals who are currently excluded through Medi-Cal if meet income requirements
– Can also purchase on Exchange program
Take Action
Contact Your Legislator and Ask them to Co-Sponsor!
