The Historic Immigration Reform Bill and What It Means for Health Coverage and Care for Immigrants

The Senate passed an historic immigration reform bill last Thursday. While the House of Representatives still must pass a bill, this legislation could have far-reaching effects on the health of the millions of currently undocumented immigrants in our country.

Today, undocumented immigrants are not able to fully participate in American society, despite coming to this country with the hopes of working hard to create a better life for their families. For example, they are vulnerable to discrimination and abuse in the workplace, have no meaningful access to the justice system, and often live in fear of seeing their families broken apart. One of the many challenges that they face is that they have little access to health care and too often must leave medical conditions untreated while living in fear of being forced to leave the country.

Congress took up comprehensive immigration reform to fix this broken system and bring these families out of the shadows. The Senate bill provides a path to citizenship. The immigrant community and its allies have been waiting for this victory for a long time. However, the path to citizenship laid out in the bill is very difficult—both due to the various penalties and restrictions on who can actually become a citizen and because immigrants will still have trouble getting access to important health care.

For a 10 year “provisional” period, likely longer for most, previously undocumented immigrants will not have access to any safety-net programs. This means they will not be eligible for Medicare, Medicaid, or the financial assistance available under the Affordable Care Act to help them buy health insurance. Once they earn their green card, they will still be unable to sign up for Medicare, Medicaid, food stamps, and other safety-net programs for five years. However, at this point, they will be eligible for the financial assistance to help them purchase coverage in their state’s health insurance marketplace as well as the cost-sharing assistance available under the Affordable Care Act.

For more than 10 years, a newly documented immigrant will have to find a way to get health care while also paying thousands of dollars in fines, meeting work requirements, and undergoing exacting background checks. This tough path was apparently necessary for this legislation to pass the Senate with strong bipartisan support, as it did. If Congress were to make it any stricter, they would be in danger of creating an unworkable system.

The House of Representatives has yet to act on immigration reform, but proposals in that chamber have been troubling. Some proposals would force undocumented immigrants to risk deportation if they get sick while waiting to be a citizen and can’t pay their bills. Others would refuse documentation for anyone who can’t afford to buy health insurance, but would provide no assistance to purchase this required coverage. As Congress moves forward, we must ensure that immigration reform does not take this course, and instead that it provides undocumented immigrants with a fair,  just, and realistic path to citizenship.

For a detailed analysis of the bill, including the nuances of its coverage provisions, visit the National Immigration Law Center’s website.