Adrianna is the sole caregiver to her two grandchildren in the rural Rio Grande Valley of Texas. The children are unable to see their mother, who is in Mexico caring for their sibling with leukemia. Since Adrianna's own husband was deported, she has juggled not only raising the young children but also being the family's only breadwinner. Adrianna worries regularly about who would care for her grandkids if something happens to her because she lives with pain from a recurring health condition. On top of all this, she can't even get in to see a doctor — though she works hard and pays income taxes — because she's barred from accessing Medicare, Medicaid and other affordable health coverage programs due to her immigration status. Adrianna is an undocumented immigrant.
I'm sad and disappointed to say that if the administration's budget is adopted, many other immigrant women across the country will be faced with similar worries. One month ago today, President Obama announced in his budget proposal that he plans to force tens of thousands of currently eligible immigrants off of Medicare and explicitly require citizenship or proof of lawful presence. Previously, many immigrants were still able to access Medicare through private Medicare Advantage programs. This change would exacerbate an already bad situation for immigrants.
Right now, in addition to the millions of undocumented immigrants who are expressly barred from care, many lawfully present immigrants, like those who qualify for the Deferred Action for Childhood Arrivals (DACA) program, are also prevented from accessing medical help. In addition, a mandatory five-year waiting period and restrictive, outdated welfare policies block even more immigrants, including those who are here lawfully, from accessing the health care system for which they are helping to pay.
This "crackdown" on immigrants' access — to the health programs which their tax dollars help to support — hurts the economy, ignores immigrant contributions to the country, and makes it even harder for women like Adrianna to survive and succeed.
As the leader of an organization devoted to the health of Latinas, I want to say plainly that this budget proposal is bad policy, especially for women and families. Some policymakers, thankfully, are working to change this. Days after the administration released its budget proposal, Rep. Michelle Lujan Grisham (D-NM) introduced the Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act of 2014. This bill would restore access to affordable health coverage for immigrants authorized to live and work in the United States.
Immigrant women and families work hard, pay taxes, and contribute to our economy. Yet, the administration's budget would like to explicitly deny them the care their tax dollars pay for. I'd ask Congress to remember that immigrant women are important economic drivers, workers, and critical members of their families. They encourage their families to learn English and pursue naturalization, and they play vital roles in the service economy — including providing much of the country's child and elder care. They're even more likely to start businesses than their native-born counterparts. Immigrant women now account for 40 percent of all immigrant business owners.
Even though these women and families contribute to the system, Adrianna and women like her are forced to live in fear and pain because they lack health coverage — meaning one accident or illness could threaten their family's economic and emotional security. This can't be good for these families or their communities.
The administration's proposal is particularly egregious because immigrant women disproportionately suffer from almost entirely preventable and treatable health conditions like cervical cancer. Most cervical cancers are caused by a virus for which vaccines have been developed and early detection tests and tools are well established. Yet even as cervical cancer incidence and mortality rates have declined for U.S.-born women, they've risen for immigrant women. Lack of affordable health insurance coverage and already limited access to publicly-financed health services directly contributes to immigrant women's elevated death rates from this disease.
Even worse, because immigrant women like Adrianna are the backbones of their families and communities, when they suffer, their entire families join them.
President Obama has done much for the health of Latinas and our families by advancing the Affordable Care Act and protecting access to contraception. I hope that Congress continues this work by not making access to health care more difficult for millions of families.
Imagine if your children had to watch you go to work, in pain, every day for a entirely treatable condition, simply because you're barred from accessing publicly-financed or subsidized health care. Even worse, imagine your children fearing you might die from an undiagnosed condition because you have no health insurance and can't afford diagnosis or treatment. This is a reality for many immigrant families.
Contrary to what many legislators apparently believe, eliminating access to health care doesn't cause the need for it to evaporate. It simply prevents immigrants from accessing preventive care or forces them to delay treatment — increasing medical costs, suffering, and strain on the nation's under-resourced and costly emergency services.
Between 2002 and 2009, immigrants contributed $115 billion more to the Medicare Trust Fund than they took out. Findings from the Government Accountability Office echoed the benefits of keeping immigrants on Medicare. They found that those who previously had continuous insurance through Medicare had lower total healthcare spending. So why are we trying to make it more difficult for them to access care?
Poll after poll also shows that Americans want our country moving forward on immigration reform — not backward.
The solution is clear: End existing harmful restrictions that exclude eligible immigrants from the health care they need and don't compound the problem by backing this aspect of the administration's plan. This will allow immigrants — documented and undocumented — to participate in the programs into which they are paying. Federal law calls on both the House and Senate to act on a non-binding resolution to set the framework for next year's budget by April 15, a deadline rarely met. However, I urge Congress to make health care more accessible for immigrants, not less. That will benefit us all.
Jessica González-Rojas is the executive director of the National Latina Institute for Reproductive Health.
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This article is from the archive of our partner National Journal.