immigrants and reproductive justice

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

OHWV

NJCT

MA

ME

RI

VA

NHMI

Health Coverage for Immigrant Children | January 2014

KEYMedicaid/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

OHWV

NJCT

MA

ME

RI

VA

NHMI

Health Coverage for Pregnant Women | February 2014

KEYMedicaid 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!

Thank You!

Contact Info:Lillian Hewko

lhewko@nwhn.org