Tuesday, April 1, 2014

“Everybody In, Nobody Out:” Securing the Right to Health for Immigrant Communities

Today, co-editor Mariah McGill, Assistant Director of NUSL Program on Human Rights and the Global Economy, shares lessons learned from the Vermont campaign for universal health care.

She writes:

As others have noted here and here, the UN Human Rights Committee recently reviewed the US compliance with its obligations under the International Covenant on Civil and political rights.

The Committee’s concluding observations highlighted the discriminatory treatment of documented and undocumented immigrants under the Affordable Care Act (ACA).  While the ACA will significantly expand health care access to millions of Americans, documented and undocumented immigrants are denied full coverage under the Act.

Under the ACA, undocumented immigrants are excluded from purchasing health insurance plans on the exchanges and are generally excluded from receiving health care through federally-funded programs such as Medicaid, Medicare or the Children’s Health Insurance Program (CHIP). Immigrants who are residing lawfully in the United States are able to purchase health insurance on the exchanges but depending on the state, may have to wait five years before becoming eligible for Medicaid or CHIP.  As the Committee notes, the consequence of these discriminatory policies is that millions of people including children will be unable to access affordable health care in a timely manner.

Although federal action is required to reverse the discriminatory aspects of the ACA, states can play a role in ameliorating the impact of the discriminatory policies. For example, states have the authority to waive the five-year waiting period for the Medicaid and CHIP programs for pregnant women and children who are lawfully present.  Additionally, states could create separate state-funded programs to provide health care coverage for undocumented immigrants as California is considering.

As health care advocates consider the best way to build on the Committee’s concluding observations and ensure immigrants receive the health care they need, it may be helpful to look to the Vermont experience.  Vermont activists launched the “Healthcare is a Human Right Campaign” in 2008 and used a human rights framework to build a grassroots movement for universal health care.  The result of their efforts was the passage of Act 48 in 2011 which enshrined human rights principles into Vermont law and created a roadmap for a universal health care system known as Green Mountain Care.

Just before final passage of Act 48, the Vermont Senate amended the legislation to exclude undocumented immigrants from coverage under Green Mountain Care.  This move was regarded as an attempt to divide supporters of universal health care and undermine support for the bill.  Vermont health care activists had long worried that health care coverage for immigrants would be used as a “wedge issue” and had prepared for this eventuality by educating Vermonters on the universality of human rights. 

In response to the amendment, organizers reminded Vermonters that all people are entitled to health care regardless of their immigration status. Thousands of Vermonters signed petitions calling for the removal of the amendment while volunteers gathered every day at the Statehouse to personally lobby for the removal of the amendment.  Thanks to these efforts, the amendment was stripped from the final bill and the Vermont Legislature is currently studying options to include all immigrant residents in Vermont in the new Green Mountain Care system.

Expanding health care access to immigrants, particularly undocumented immigrants remains a controversial issue politically.  After all, the exclusion of immigrants from the ACA in the first place was designed to appeal to moderate and conservative Democrats in the U.S. Congress in order to ensure their support for the legislation. The Vermont experience demonstrates the power that human rights-based arguments can have in building broad based grassroots support for ending health care policies that discriminate against immigrants.

 

 

 

https://lawprofessors.typepad.com/human_rights/2014/04/everybody-in-nobody-out-securing-the-right-to-health-for-immigrant-communities.html

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Comments

This is a very interesting article as our son a US citizen wishes to sponsor us for a green card to be closer to the Grandchildren. We are respectively 78 & 77 years old and try as I might I have been unable to obtain a positive answer regarding Healthcare coverage that would be available to us in Vermont.

Posted by: Richard Davies | Sep 10, 2014 6:03:05 AM

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