What Does ‘Health Care for All’ Mean for Immigrant Families?

By Madison Hardee

In today’s discussions about health care, many policymakers at the national, state, and local levels are talking about health care for all. When drafting these proposals, we encourage policymakers to explicitly include immigrants in the definition of “all.” As advocates for children and families, CLASP knows that society is better off when everyone—including parents and children, citizens and non-citizens—has access to health care. Like all children, those in immigrant families do best when their parents and caregivers are mentally and physically healthy and able to care for them. And the likelihood that children are insured increases significantly when their parents are insured. 

Under current law, access to health coverage for immigrant families is a complicated patchwork of policies that vary from state to state. Undocumented immigrants are not eligible to enroll in federally funded Medicaid or Children’s Health Insurance Program (CHIP) or to purchase coverage through the Affordable Care Act (ACA) Marketplaces. While lawfully present immigrants may use Marketplace tax credits, Medicaid eligibility is generally limited to immigrants deemed ‘qualified.’ Most newly qualified immigrants have a five-year bar before they can become eligible. Recognizing the importance of providing prenatal and early childhood health care, a growing majority of states have opted to provide health care to all lawfully residing pregnant women and children without a five-year waiting period. Twenty-one states use CHIP funding to provide coverage for income-eligible pregnant women regardless of immigration status. 

Not surprisingly, immigrants are often confused about their eligibility for benefits. Many people in mixed-status families are not aware that some family members are eligible for health coverage, and non-citizens face complicated administrative burdens because caseworkers aren’t familiar with foreign identity documents.

In recent years, a few states—including Washington, D.C.—have elected to use state funds to provide health care coverage to all children regardless of immigration status. However, with parents’ health and wellbeing inextricably linked to that of their children, it’s not enough to expand coverage to immigrant children and leave their parents behind. 
Recently, federal, state, and local leaders have moved toward more inclusive proposals. On his first day in office, Governor Gavin Newsom proposed a budget that would make California the first state to provide coverage to undocumented young adults through its Medicaid program. The following day, New York City Mayor Bill de Blasio announced an even more ambitious program that would provide access to health care for all city residents—including hundreds of thousands of undocumented residents who currently lack health insurance. 

At the national level, last week Rep. Pramila Jayapal (D-Wash), together with more than 100 co-sponsors, introduced a Medicare-for-All bill premised on the fundamental belief that health care should be a human right. The bill is inclusive of all immigrants—adults and children, documented and undocumented—and unequivocally states that the secretary of Health and Human Services (HHS) shall “ensure that every person in the United States has access to health care.” Other federal bills that have been introduced would make progress on expanding access to health coverage, but only include certain categories of immigrants or delegate the authority for determining immigrant eligibility to the Secretary of Health and Human Services. 

In the coming months, we are likely to see more proposals that seek to expand health care. We urge policymakers to consider proposals that truly provide coverage for all—including undocumented parents and their children—to ensure that every person in the United States, regardless of age or immigration status, is able to get affordable, comprehensive health care. This inclusive concept of health care for all is essential for the wellbeing and long-term success of immigrants and their families, as well as the future of our country.