Immigrant Health and Family Support Issues

In 1996, the U.S. welfare system was overhauled by the “Welfare Reform” bill, and changed into the Temporary Assistance to Needy Families (TANF) program. The new TANF program restricted legal immigrant access to federal work support programs, including Medicaid and Food Stamps, despite the fact that immigrants pay taxes that support the very programs from which they are banned access.

Under the new TANF program, most legal immigrants who entered after August 22, 1996, were banned from receiving federal public benefits for the first five years that they lived in the United States. The restrictions to the Supplemental Security Income (SSI) Program were even greater. These barriers to regular health care and other programs have forced low-income legal immigrants either to avoid using health care services or to use costly emergency rooms as their main source of medical care.

Furthermore, despite the fact that many undocumented immigrants live, work, and pay taxes in this country, they cannot access public safety net programs, with the exception of emergency Medicaid. In recent months there have been a number of legislative proposals directed at immigrant communities which would affect their access to health care. Many of these proposals, which require hospitals to document their treatment of undocumented immigrants, would create a “chill factor” within these communities. The majority of undocumented immigrants live in mixed-status families, or households where one or more family member may be of lawful status. Therefore, other family members, often citizen children, might avoid treatment due to the uncertain risks of going to a medical provider.

NCLR Position:

Current pieces of legislation that have the ability to expand immigrant access to public benefits include:

• Immigrant Children’s Health Improvements Act (ICHIA) - ICHIA is a bi-partisan bill which gives states the option to allow legal immigrant children and pregnant women who arrived after August 22, 1996, access to federal Medicaid and SCHIP.
• The Women Immigrants Safe Harbor (WISH) Act – This legislation would allow certain abused immigrants, including victims of domestic violence and sexual assault, to receive access to federal benefits if they are otherwise eligible. Battered immigrants cannot continue to endure abuse while they wait for needed benefits that would enable them to escape an abuser.

In addition, NCLR is strongly opposed to any legislation which would inhibit immigrant access to health care because of mandates that require inquiry or documentation of immigrant status, or the collection of biometric information. Both are violations of basic civil rights and the patient-doctor privilege.

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