The immigration reform bill proposed and passed by the Senate in June would offer nearly 11 million people a path to legal status. If enacted into law, long-time residents of the US will gain the right to vote, the chance to seek lawful employment, opportunities for college financial aid, and legal recognition within our communities. But regardless of your opinion on the bill, there is one glaring deficiency: it would do nothing to meet the immediate family planning and reproductive health needs of immigrant women.
While the Senate bill provides a path to citizenship, it would require a wait of 15 years or more before an immigrant would become eligible to receive Medicaid benefits, including family planning and reproductive health. Such a wait would effectively deny many women in this country the kind of reproductive health care that we seek to provide—through international assistance— to women in developing countries.
If the Senate bill passes through the House without change and is signed into law, it would allow undocumented immigrants already living within the US borders to step forward and begin the process of attaining citizenship. People who have been residing in the US prior to December 21st, 2011, would be eligible to apply for citizenship under the law, but it would be a long process. First, they would have to change their status to become a “registered provisional immigrant (RPI).” Then, after a ten year waiting period, an RPI could adjust their status to “lawful permanent resident.”
During the 10-year waiting period as an RPI, immigrants are barred from receiving nonemergency Medicaid and also remain ineligible for assistance from the Affordable Care Act. Private insurance is astronomically expensive for low- and middle- income families without the federal subsidies put in place by the Affordable Care Act. RPIs cannot receive tax credits from the Affordable Care Act, and, thus, they will likely remain uninsured throughout the 10-year waiting period. RPIs can only access limited public programs, such as WIC (supplemental nutrition programs for women and children).1 These programs alone are inadequate because they do not provide preventative care or comprehensive sexual and reproductive health services.
Following the achievement of lawful permanent residency, there is an additional “five-year bar” that would prevent legal American residents from receiving aid from federal benefit programs such as Medicaid. That means, in effect, a fifteen-year wait to receive health care. This is especially detrimental for young women of reproductive age who are pregnant or who need access to contraceptives. Currently, the cost of giving birth in a hospital is an average of $32,000 for a vaginal delivery and $51,000 for a C-section. Just for this common medical procedure, the costs are impossibly high. Undocumented immigrants, however, who want to avoid an unplanned pregnancy and the associated costs of bringing a child into this world, would be ineligible for Medicaid family planning services.
The U.S. is a major provider of family planning and reproductive health care services to women in developing countries. The U.S. spends over $600 million a year in support of the UN’s goal of ensuring “universal access to reproductive health care.” If women in developing countries need access to family planning and other reproductive health care services, the same reasoning should apply to women in this country, regardless of their immigration status.
Posted by Grace Benson, Public Policy Fellow