Though the Affordable Care Act (ACA) will go a long way toward ensuring access to quality healthcare for most LGBT individuals, many LGBT immigrants are still prohibited from obtaining the affordable health care they need. Despite being authorized to live and work in the United States, many immigrants—including LGBT immigrants—are ineligible for affordable health coverage and care through vital programs like Medicaid and the Children's Health Insurance Program (CHIP).
Many immigrants are subject to a ban that makes them ineligible for federal Medicaid and CHIP for at least the first five years they are authorized to live and work in the United States, and other lawfully present immigrants who do not fall into an outdated and restrictive list of "qualified" immigrants are barred altogether. Since immigrants—particularly LGBT immigrants—are disproportionately low-income, it can be difficult or impossible to obtain the health care they need. That means five years without insurance coverage for critical and life-saving services, including pap smears, mammograms, HIV treatment, mental health care, or pediatric care for children.
Young people granted status through "Deferred Action for Childhood Arrivals" (DACA) are forced to wait even longer. DACA refers to a program enacted in 2012 that allows undocumented people ages 15-30 who arrived in the US as children (and who are currently in school or working) to remain here for renewable two-year periods. While they are considered lawfully present and are eligible to work and pay into public health benefits systems, they are prevented from accessing affordable care. Currently, people with DACA status are ineligible for federal Medicaid or CHIP coverage and the years they live in the United States with DACA status will not count toward the five years of lawful presence required before they become eligible. To add insult to injury, these young people are even ineligible to purchase private health insurance on the ACA exchange—with or without federal subsidies.
Many LGBT immigrants come to the US after fleeing interpersonal and state abuse based on their sexual orientation or gender identity. However, once they arrive, LGBT immigrants face a number of challenges to obtaining affordable and culturally competent health care. While the ACA will continue to combat the discrimination LGBT people face in the health care system due to lack of cultural competency, all of its positive effects are out of reach for LGBT immigrants because of gaps in coverage. The existing barriers to affordable health care disenfranchise hard-working LGBT immigrants who come to the United States to have a better life, only to encounter difficulty getting the care they need. Moreover, because LGBT immigrants are much less likely than non-immigrants to be able to access health care through their jobs, they are putting work into a system that does not support them.
However, new legislation introduced by Congresswoman Michelle Lujan Grisham would change these realities for good. The Health Equity and Access under the Law for Immigrant Women and Families Act of 2014 ("HEAL Immigrant Women and Families Act" for short) restores access to Medicaid and CHIP for immigrants authorized to live and work in the United States who are otherwise eligible. The bill also extends full participation in the ACA to young people granted status under DACA.
The HEAL Immigrant Women and Families Act is especially important for families. LGBT families are more likely to live in poverty than non-LGBT families, meaning health care on the private market is often out of reach. We know that LGBT people deserve the same access to health care as non-LGBT people, and this should include LGBT immigrants. The HEAL Immigrant Women and Families Act would bridge the gaps in the ACA, Medicaid, and CHIP by extending needed care options to immigrants, and in so doing, strengthen our workplace, our economy, and our communities. NCLR applauds Congresswoman Lujan Grisham for introducing the HEAL Immigrant Women and Families Act, and we encourage other members of Congress who support the LGBT community to stand beside her in expanding the health care options for many LGBT immigrants. Please show your support for the HEAL Immigrant Women and Families Act by signing this pledge, put together by the National Latina Institute for Reproductive Health. Please check out @NLIRH's twitter timeline for more information on how this important bill will impact our communities!