It is an understatement to say our current immigration policies and practices hinder, instead of promote, immigrant integration.

Aggressive enforcement practices tear families apart and undermine the safety of our communities. Our government’s failure to establish a path to citizenship perpetuates labor exploitation, threatens families’ economic security, and undermines equality of opportunity. Yet in the discussions of immigrant integration and current immigration policies, women’s access to health care, including reproductive health care, is often overlooked.

Access to health care must be included in the conversation about integration, as health is foundational to equality of opportunity. How can Latinas take advantage of opportunities without access to primary and preventive care? How can Latinas and immigrant women start new businesses, pursue education, and serve their communities without the ability to plan if, and when, to start a family? How can immigrant women live full lives without the ability to prevent, detect, and treat serious health concerns like cervical cancer and sexually transmitted infections?

Far too many in our community face an impossible choice: forgo care and suffer the consequences, or visit the emergency room and undermine their economic security. Maria*, a young Latina mother of two who lives without health insurance coverage, knows this all too well.

A health incident, which could have been prevented with better access to primary care, put her in the emergency room. She received a $500.00 bill for one hour of care, and she struggled to comprehend how she would be able to pay. Stories like Maria’s are far too common and demonstrate that many in our community have no place to turn. Maria now says:

“Y ahora cuando me enfermo me tomo un tylenol y me tengo que aguantar. No puedo pagar una visita al hospital.”

“And now when I get sick, I take a Tylenol and I have to put up with it. I cannot afford a visit to the hospital.”

Yet policies excluding immigrants from access to health care have become entrenched in our laws. From the historic restrictions on immigrant women’s access to prenatal care to the 1996 welfare reform restricting eligibility for Medicaid, the health of immigrant women has been devalued. And just 6 weeks after President Obama announced a new program, Deferred Action for Childhood Arrivals (DACA), which seeks to integrate eligible young DREAMers into society, two changes to existing federal policy were made to exclude this group from affordable health coverage options under the Affordable Care Act (ACA), or health reform law, Medicaid, and the Children’s Health Insurance Program (CHIP). These policies will dramatically limit access to reproductive health care, including contraception, Pap tests, and prenatal care for immigrant women granted DACA. These policies will impact the health of entire families and communities.

Maria, who came to the United States from Mexico at the age of 8 and is DACA eligible, reflects:

“La exclusión de los indocumentados a los provisos de la ACA me duele mucho. Me causa mucha ansiedad porque mis hijos están chiquitos y pues es muy difícil.”

“The exclusions of the undocumented from the ACA hit me hard. They cause me much anxiety because my children are young and it is very difficult.”

She adds:

"No es justo que tantos de nosotros (familias imigrantes) trabajemos tanto en este país y ni siquiera podemos ir al doctor cuando nos enfermamos...Que cuando ya nos estamos muriendo, apenas podemos ir a la emergencia."

“It is not just that so many of us (immigrant families) work so hard in this country and we cannot go to the doctor when we are sick…. That when we are dying, we can barely go to the emergency room.”

Integration is not just about work permits and paying taxes: it is about providing immigrants the opportunity to achieve their dreams here in the United States and to support their loves ones and family. Access to quality, affordable, culturally -- and linguistically -- appropriate care, including reproductive health care, is central to the pursuit of those opportunities.

Latinas like Maria are working to change the conversation from stigmatization and exclusion toward justice and inclusion. Through her participation in the National Latina Institute for Reproductive Health’s Young Moms Working Group, she supports other young mothers who face similar struggles. She works to lift the voices of young moms and immigrant women and to raise awareness of the barriers to health care they face as women, as young mothers, and as new Americans. As Congress drafts up proposals for immigration reform, Latinas like Maria will make sure her representatives recognize her contributions, understand her struggles, and join her in the fight to bring justice to our immigration policies.

The National Latina Institute for Reproductive Health joins Latinas across the country in the call for reforms to our immigration policies that advance the health of our families, respect the dignity of our lives, and bring justice to our immigrant communities. Immigration reform must include a path to citizenship for the 11 million, and this path must expand access to quality, affordable health care. Reforms must address and correct historic exclusions in access to health care, including in the landmark Affordable Care Act. Failure to do so will only continue to hinder true integration and equality of opportunity for Latinas, their families, and their communities.

For more information about the National Latina Institute for Reproductive Health, please visit www.latinainstitute.org.

*Name has been changed to respect confidentiality.