Opinion

Let’s Adopt A Budget That Doesn’t Hurt Immigrant Women And Families

Their health should not be sacrificed for political gain.

Jessica González-Rojas is the executive director of the National Latina Institute for Reproductive Health. The institute is the only national reproductive justice organization dedicated to building Latina power to advance health, dignity and justice for the 26 million Latinas, their families, and communities in the United States.    
National Journal
Jessica González-Rojas
April 3, 2014, 12:55 a.m.

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

HAVE AN OPIN­ION ON POLICY AND CHAN­GING DEMO­GRAPH­ICS?

The Next Amer­ica wel­comes op-ed pieces that ex­plore the polit­ic­al, eco­nom­ic and so­cial im­pacts of the pro­found ra­cial and cul­tur­al changes fa­cing our na­tion, par­tic­u­larly rel­ev­ant to edu­ca­tion, eco­nomy, the work­force and health. Email Jan­ell Ross at jross@na­tion­al­journ­al.com. Please fol­low us on Twit­ter and Face­book.

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