On June 15, 2012, the Obama Administration announced a new policy, Deferred Action for Childhood Arrivals (DACA) that allows undocumented youth who meet specific requirements to apply for a two-year protection from deportation and for work authorization. When the policy was announced, advocates for immigrant women, including the National Latina Institute for Reproductive Health (NLIRH), joined the immigrant rights communities to celebrate the decision, while recognizing that changes in immigration policy that promote fairness, justice, and opportunity also advance reproductive justice and for immigrant Latinas, their families, and their communities.

Unfortunately, in late August, just after United States Citizenship and Immigration Services (USCIS) began receiving applications for DACA, the Administration announced two changes to existing federal policy that effectively strip access to health care for young DREAMers authorized to reside and work in this country.

Prior to the policy changes, those granted DACA would have the same access to health care as others granted deferred action, a pre-existing designation that granted temporary relief from deportation to other immigrants. Under the changes made in late August, DACA youth who are denied health care coverage due to a pre-existing condition (which for women could be a previous C-section, or domestic violence, for example) will no longer be able to purchase a plan in the Pre-Existing Condition Insurance Program (PCIP) created by the health reform law or Affordable Care Act (ACA). DACA youth are similarly prohibited from purchasing a health plan in insurance exchanges that will be available in 2014, and are ineligible to apply for federal assistance in purchasing a plan. And according to federal guidance issued by the Centers for Medicare and Medicaid Services (CMS), pregnant women and youth under 21 with DACA status are barred from health coverage in Medicaid and the Children’s Health Insurance Program (CHIP), unless that state has a separate, state-funded program.

The decision has far-reaching implications for immigrant women’s access to quality, affordable health care, including reproductive health care. The decision undermines the goals of the ACA expanding access to health insurance, reducing racial and ethnic health disparities, and lowering health care costs by prioritizing prevention and insuring the previously uninsured. The policies are particularly harmful for immigrant women as they:

• Further entrench long-standing barriers to health care for immigrant women. Current immigration laws deny a path to citizenship for immigrants found to utilize public benefits, including health care.  On top of this, Congress has, in the past three decade, created new restrictions on immigrant women’s access to health care and other public benefits, in the forms of 5-year (or other multi-year) bars on eligibility for public insurance, documentation requirements, and other barriers. These policies, in addition to undermining immigrant integration and the health and economic security of our immigrant families and communities, create a “chilling effect,” and discourage immigrant utilization of safety net services they are eligible for.  These policies disproportionately impact women, who are more likely to receive safety net services for their children;
• Undermine the safety net, which is critical to immigrant women and communities. Immigrant women are far less likely than U.S. born women to have access to employer-sponsored coverage and private health insurance generally. Immigrant women are overrepresented in low-wage sectors that simultaneously fail to provide employer-sponsored coverage, while also exposing workers to strenuous and dangerous work. Nearly two-thirds of noncitizen Latina workers (66%) are not covered by employment-based health care, and this contributes to high uninsurance rates for Latinas overall (37.3% of Latinas are uninsured for health care.) This is also true of the Asian Pacific Islander (API) community, where lack of employer-sponsored coverage contributes to the fact that 18.2% of API women live without health insurance;
• Leave very few options for immigrant women to receive contraception, cervical cancer screenings, prenatal care and other important health care. Due to these policies, immigrant women granted DACA may only be able to access care through already-stressed safety net providers and state-funded programs. For pregnant immigrant women, Emergency Medicaid, which covers important labor and delivery services but does not cover prenatal care, may be the only available coverage for reproductive health care. In about 15 states, immigrant women may have access to reproductive health care under the “unborn child” option in CHIP, which utilizes the troubling fetal personhood frame to provide health care for a woman’s pregnancy, but not to the woman herself.

The restrictions on access to health care for those granted DACA will hurt women, who face a number of oppressions and injustices due to their gender, national origin and race, and immigration status. That is why advocates for immigrant women are calling on President Obama to affirm his commitment to the principles of the ACA, and to advance the health of our immigrant families and communities.

On December 18, International Migrant’s Day, advocates and communities across the country will call the White House to demand restored access to health care for DREAMers granted DACA. We hope you will contribute your voice to the effort to restore access to health care for our young DREAMers, so as to promote health, dignity, and justice for immigrant women, their families, and their communities.

For more information, please visit the website of the National Latina Institute for Reproductive Health at http://www.latinainstitute.org.