Tag Archives: Affordable Care Act

2013: New opportunities for healthy immigration reform?

9 Jan

The Curious Ostrich has big plans for 2013! We are now moving to a monthly format, providing readers with in-depth analysis and commentary on the public health impact of immigration policies and national conversations around immigration. As always, our mission is to bring attention to the ways immigration policies affect health and to provide information and resources for health and immigration advocates alike. Want regular updates on immigration issues? Like our Facebook page!TCO cover

Over the course of 2012, a number of policies and events across the country significantly, and often negatively, affected the health of immigrants and their communities. Deportations continued at an all time high, separating families and at great cost to our economy. Due to programs such as Secure Communities 1.6 million people were deported during President Obama’s first term. Our nation’s growing immigration enforcement system now receives more funding than all other federal enforcement agencies combined. This focus on enforcement and a militarized border increased border violence and resulted in many deaths, some perpetrated  by the US Border Patrol itself.

Immigrants also continue to be denied many basic rights. For example, while the Affordable Care Act (ACA) goes a long way in expanding access to health insurance, undocumented immigrants and Deferred Action for Childhood Arrivals-approved individuals are barred from new health insurance programs. At the state level, although the Supreme Court knocked down many of the provisions in Arizona’s immigration bill SB 1070,  the “paper’s please” provision will move forward.  Other states continue to follow Arizona’s lead in anti-immigrant legislation.

The impact of xenophobia and anti-immigrant politicking is not limited to immigrant communities. For example, in 2012 the Violence Against Women Act, a traditionally non-controversial, bi-partisan bill, failed to be reauthorized for the first time in its history. This was in part due to Republican supposed opposition to protections for immigrant women.

In 2012, we also saw promising policies and inspiring activism by undocumented immigrants, particularly youth. Influenced by ongoing activism by DREAMers, President Obama granted deferred action to “childhood arrivals” (DACA), creating the largest opening in many years for undocumented individuals to gain work permission and protection from deportation. While not a long-term solution, DACA created opportunities for many young immigrants.

Exciting grassroots mobilizations also helped raise the profile of immigrant issues and pushed forward a more progressive policy agenda. The Caravan for Peace turned attention to the human impact of border violence and the United State’s role in drug war violence; undocumented youth are using art and creativity to assert their rights; DREAMers sat-in at Obama campaign offices; the Undocubus shared stories at the Democratic National Convention; and the Campaign for the American Dream team walked from San Francisco to Washington, D.C. to raise awareness about immigration policy.

Moving into 2013

Building on this momentum, 2013 brings new opportunities for making immigration policy more just and protecting immigrant communities. President Obama’s re-election turned new attention to the power of communities of color in our political system and we now have the most diverse Congress in US history. Polling suggests that the public and elected officials are ready to consider immigration reform. President Obama has repeatedly stated that comprehensive immigration reform will be a priority early on in his second administration. However, for too long, political debates about immigration have focused on controlling immigration through the criminalization and stereotyping of immigrants.  Therefore, we hope to see these policy discussions and decisions acknowledge the importance of immigrants to our society and economy and affirm that all people, including immigrants and regardless of their immigration status, have rights as residents of this nation.  Specific policies that we would like to see from the 113th congress include:

      • Create a path to citizenship for undocumented immigrants currently in the US.  The increasing numbers of young immigrants applying for deferred action demonstrates that creating a process for undocumented immigrants to apply for papers is not only relatively politically non-controversial, but is feasible and has tremendous positive impacts. This is a start, but temporary status for a small portion of undocumented immigrants is not enough.  There are still roughly 11 million individuals who lack papers and a path to citizenship. This is an injustice, not only to these individuals, but to their families and communities and the nation as a whole.
      • Reduce deportations and keep families together.  Enforcement programs and deportations needlessly tear people from their jobs, communities and families, with devastating emotional and economic impacts.  A simple fix would be to end programs such as Secure Communities.  In addition, policies are needed to end the fear that deportations have caused by creating clear delineations between local police officers and Immigration and Customs Enforcement.
      • Create accountability over and reform the detention system. The unregulated and unhealthy network of privatized detention centers must be reformed and regulated. This should include expanding accountability and oversight for current detention centers.  The all-historic-high number of detention beds in centers and county jails creates a gross profit motive and should be reduced.
      • End the militarization of the border.  Border fence and patrolling policies throw money into militarization, rather than the true safety of people in the United States.  There should be an end to financial support for the border fence, reduction in funding for the Border Patrol, and increased oversight over the Border Patrol, including the training and background of officers and their use of surveillance technology.
      • Increase access to education and social services for all immigrants.  Immigrants should be positively included in public policies.  This is a matter of both fairness and of effective crafting of public policies, as economic, social service and health policies ultimately have an impact on immigrant communities, such as the Affordable Care Act and the Violence Against Women Act.

The connection to health

At The Curious Ostrich, we believe that all of these policies and their resulting challenges and opportunities for immigrants are public health issues. Immigration policies, and related social and economic policies, directly impact the health of immigrants in a number of ways – from reduced access to essential services and resources to the  fear and stress that result from discrimination, criminalization and deportation. Over the course of 2013, we will continue to explore these links between immigration policies and health:

      • Access to health care— Many people are barred or have limited access to health insurance and health care services due to their immigration status. Access to regular primary care is important in preventing many diseases (e.g. diabetes), while limited emergency care services results in unnecessary deaths.
      • Diminished rights and protections— Fear of deportation diminishes the rights of undocumented individuals by shaping their decisions about accessing services such as education or police protection. For instance, many undocumented workers are victims of wage theft, yet they do not have legal recourse without risking deportation.
      • Access to resources— Diminished rights lead to reduced access to resources to lead a healthy life. For example, undocumented immigrants may choose not to access public resources, such as education or social services, because they believe they are not eligible or they are afraid of coming into contact with government officials.
      • Discrimination— There is widespread anti-immigrant sentiment embedded in our national policy and media discourses, and anti-immigrant groups continue to advocate effectively for policies that devalue and dehumanize immigrants because of their lack of legal standing. From conservative politicians campaigning on deportation policies, to widespread discriminatory commentary in the news, there is a strong national narrative that a lack of papers justifies less-than-humane treatment.

There are feasible policy solutions that can reduce the risks to and protect the health of immigrant communities. There are dynamic and mobilized advocates who will continue to fight for the rights of immigrants.  Public health advocates can play a critical role.  Therefore, in 2013, our hope is to see not a continuation of the short-term and enforcement-focused policies often associated with “comprehensive” immigration reform, but rather the promotion of healthy immigration reform.

Support health insurance access for deferred action youth! 10/20-10/25

25 Oct

Submit comments to HHS to allow DACA-approved individuals to participate in the Affordable Care Act – [Deadline October 29th]
The California Pan-Ethnic Health Network has released a call for advocates to submit comments to the Department of Health and Human Services to speak out against the recent decision to exclude DACA-eligible individuals from the Affordable Care Act.  Anyone can submit comments and, to make the job easier, a sample letter is available.  Simply follow these instructions to submit comments electronically:

  • Step 1: Go to www.regulations.gov
  • Step 2: Search for document ID ” CMS–9995–IFC2″ to find the regulation on DACA and health care. Make sure you are commenting on the “Pre-Existing Condition Insurance Plan” Interim Final Rule (Thanks to Natalie for the clarification)
  • Step 3: Click on “Comment Now” button to submit comments

CPHEN’s call reminds us that this policy:

  • Runs counter to the primary goal of the ACA – to expand access to affordable health coverage.
  • Will lead to higher health insurance premiums for everyone by excluding young, healthy individuals from enrolling in coverage in the Health Benefit Exchange.
  • Will likely lead to poorer health outcomes and increase health disparities by denying young immigrants the care they need.

Despite this effort to reverse the recent HHS decision, other undocumented immigrants and legal permanent residents who have lived in the U.S. for less than five years are excluded from new coverage opportunities under the Affordable Care Act.  States such as California that have large immigrant populations will continue to have many uninsured individuals.  For more information, visit The Kaiser Family Foundation, which provides an excellent overview of immigrants’ eligibility to participate in health coverage expansion from the Affordable Care Act.

“Adios Arpaio” in full force
A vibrant “Adios Arpaio” campaign has been actively registering voters and mobilizing to ouster Joe Arpaio from his position as Sherriff of Maricopa County, Arizona.  Just this week, a lawsuit was filed against the sheriff for the death of Ernest “Marty” Atencio while in county custody.  The Adios Arpaio campaign is made up of a coalition of Latino and immigrant rights advocates and local unions, such as UNITE HERE, and has registered 34,000 voters.  Particularly active are students from the local high schools who have become politically mobilized because, in the words of one, “they have the same issue inside, that they can’t stand discrimination against Latinos.”  Organizers say this is a long-term strategy to mobilize the Latino vote in Arizona: “The next one will be Jan Brewer.”

President Obama says he’s confident he can achieve Comprehensive Immigration Reform during a second term
In an previously off-the-record interview with an Iowa newspaper, President Obama expressed confidence that he could achieve an comprehensive immigration reform bill during a second term, specifically, because “the Republican Party have so alienated the fastest-growing demographic group in the country, the Latino community…George Bush and Karl Rove were smart enough to understand the changing nature of America.”

ACA Denied for Deferred Action Applicants, DNC Convention, Economic Impact of Immigration Relief, 8/27- 9/3

5 Sep
Caduceus Crossed Through in front of Chicago Deferred Action Applicants

Original Photo by Nathan Weber for NY Times

Deferred Actors need not apply for health coverage through Affordable Care Act

Department of Health and Human Services made a ruling this past week that deferred action applicants would not be eligible to participate in the programs of the Affordable Care Act. Although the ACA has stated that it would be open to those who are “lawfully present,” it will exclude the 1.7 million young people who may request deferred action. The announcement comes in response to Republican criticism that deferred action would cost the country due to services it would provide to those with this new status. With this decision from the Dept. of Health and Human services, the Obama administration has made it clear that undocumented people, even those young people who submit form I-821D, will continue to be dealt a diminished set of rights.

Two weeks ago, in Arizona Jan Brewer issued  a more startling executive order that explicitly bans deferred action applicants from receiving drivers licenses, state id cards, and other local benefits.
Although there are many working to limit the rights of the deferred action applicants, there has been a flurry of fliers, handouts and websites to provide information for those who are considering pursing the process. Here are is a Fotonovela from the Rural Women’s Health Project describing deferred action, in Spanish and in English.

Immigration Rights at the DNC

The Democratic convention to nominate President Obama on the Democratic ticket is set to begin today. Although there were several prominent Latino speakers at the Republican National Convention, immigration as a topic was largely avoided. At the Democratic National Convention, we will likely likely hear more favorable arguments for immigration, especially from the likes of keynote speaker Los Angeles mayor Antonio Villaraigosa. Immigrants rights groups, such as the Undocubus: No Papers, No Fear, Ride for Justice have targeted the convention as a more receptive setting to air their concerns. Here you can see a inspiring photo album of the riders.

Economic contributions of immigrants in red states are substantial

Center for American Progress has released a report examining the economic role of immigrants in states where there has been wide support for anti-immigrant laws. The report profiles Arizona, Colorado, Florida, Nevada, New Mexico, Texas and Virginia and asks: What would happen if all undocumented immigrants in the respective state were deported? and What would happen if undocumented immigrants were given legal status? They conclude that deportations would lead to lost revenue and fewer jobs, whereas legalization would brings more money into the state.

Often anti-immigrant arguments are flung from a place of emotion. When the right-wing academics get involved, they usually cite economic reasons, jobs, services, etc.as they reason why immigrants are bad for the economy. CAP’s report undercuts those lines of reasoning and provides evidence that the restrictive and severe immigration and enforcement policies are what actually hurts the economy.

In comparison to the states included in CAP’s report, California’s legislature has considered a long list of pro-immigrant bills: the TRUST Act that would weaken S-COMM, drivers licenses for deferred action applicants, work permits for farmworkers, and protection for taxpaying undocumented immigrants.

Immigrants fight for right to unionize and vote; Hospitals grapple with how to serve undocumented, 7/23-7/30

1 Aug

Immigrant workers on strike in Wisconsin – for the right to unionize
Workers at Palermo’s frozen pizza factory in Wisconsin have been on strike since June 1, protesting the mass firing of 89 workers in May. At that time, 150 employees submitted a petition to Palermo’s indicating the intent to unionize. After workers submitted their petition, the company asked workers for legal documentation of their ability to work in the US – in cooperation with ICE, and then fired the majority of them. Labor organizers, arguing that the move was intended to prevent workers from unionizing, filed a complaint with ICE. ICE stayed the enforcement action that ended with the workers firing. This decision was in line with a December 2011 agreement between ICE and the Department of Labor to prevent ICE from engaging in enforcement efforts tied to labor disputes, and was the first time ICE has granted such an action. Workers are asking supporters to boycott Palermo’s products.

Pennsylvania voters seek injunction on voter ID law
Ten Pennsylvania voters are going to court to seek an injunction on Pennsylvania’s voter ID law, testifying that they were denied identification and, therefore, under the new law, the right to vote. A study conducted by the Washington Institute for the Study of Ethics, Race and Sexuality estimates that 1.3 million people in the state (over 14% of the voter-eligible population) do not have ID. The outcome of the Pennsylvania ruling is being closely watched, as states and courts around the country debate a number of voting laws with severe implications for the rights of communities of color and immigrant communities. To find out what is happening with voting rights in your state, check out this voting rights website in The Nation.

Access to healthcare for undocumented immigrants at risk under health care reform
Undocumented immigrants are not covered by health care reform, and there are concerns that coverage will decline as the law comes into effect. Currently, the Federal government reimburses safety-net hospitals for many of the services that are accessed by low-income communities; but these reimbursements will be cut as more individuals purchase health insurance or enroll in Medicaid. For hospitals that serve large numbers of undocumented immigrants, cuts in Federal reimbursement will make it increasingly difficult to provide care. For undocumented immigrants, who are unable to purchase insurance on the private market, this will further reduce already limited access to adequate health care services. As health care reform moves forward following the Supreme Court decision, hospitals are beginning to plan for the reduced funding and advocate for solutions that will enable them to continue providing care.

Candidates and advertisers increasingly turn to Spanish-language media
Univision and Telemundo, the largest Spanish-language television outlets in the country, are increasingly targeted in electoral media campaigns. Both stations hosted interviews with Barack and Michelle Obama and Mitt Romney. The stations are receiving a much larger share of political advertising money than in prior elections.The increasing interest in Spanish-language media is one more sign of the candidates efforts to win Latino and immigrant votes – a key constituency in November’s election.

Undocumented individuals travel to DNC to raise awareness of harmful immigration policies
A group of undocumented immigrants began a trip around the country on Monday to bring the issue of immigration policy to the center of electoral politics. The riders on the UndocuBus plan to travel through states with the harshest immigration laws – in time to bring their message to the Democratic National Convention.

Latinos and the health care reform, 10/9-10/16

17 Oct
Hastings Center LogoLatino voters support health care reform, not the insurance mandate, Latino Decisions, 10/13/11.
New resource to clarify health care reform for undocumented patients, Medical News Today, 10/13/11
Like any other group in this country, Latinos are mixed about their support for the new health care reform law. A nation wide poll of 600 Latino voters found limited support for the affordable care act. Asked whether the law should stand, 50% said yes, compared to 29% who said no. Asked whether they were in favor of mandated insurance, a much less popular, albeit necessary feature of the act, 59% were against, compared to 32% who were in favor. There was large opposition to cuts to Medicare, with 73% opposed. Adding to the confusion, there is little clarity on what the new reform means for undocumented people.
A new effort lead by the Hastings Center a non-partisan research institution will attempt to shed light on access to health care for undocumented individuals. Many assume that they or their children do not have access to the medical where this is not the case. For example, a US born child, who has undocumented parents, does have access to health care: this is not always understood.The report will investigate how doctors and organizations navigate the challenges of serving undocumented patients. Specifically, the report with look at how laws, policies, and financial constraints are dealt with to provide health care. Along with a final report, the Hastings center will put forth a website with resources for the public.In other news
Apeals court blocks part of Alabama law, Reuters, 10/14/11
Appeals filed by the DOJ and immigrants rights groups stopped the part of the law that required public schools to keep records on immigration status of students and the part making it a crime to be in the streets without papers.Immigrant Groups to DOJ: In Alabama the situation is dire, HUFFPO, 10/10/11
Ironically, many immigrants are fleeing the state during “Celebrate Hispanic Heritage Month.” The law that targets immigrants has created an atmosphere of uncertainty, and has led many in the state to leave while the courts determine where the law is constitutional. DOJ has taken a proactive role to protect individuals from abuses, meeting with immigrant groups and setting up toll-free lines for people to report abuses stemming from the new law. One Alabama Latino said, “I never thought I’d be hanging out with the FBI and the Department of Justice so much, but they’re on our side,”

Latinos in Alabama are not going down quietly, ABC News, 10/12/11
Latino workers with authorization to work are standing in solidarity with the undocumented immigrants of Alabama to protest the repressive HB56. Chicken processing plants will be closed due to the work stoppages. One web commenter stated, “We must be united to be a force, now more than ever.”

Dayton Ohio has plans to become an immigrant friendly city, Reuters, 10/13/11
In a much different approach to immigration, Dayton Ohio hopes to prevent population loss and stimulate the economy by legislating a welcoming environment. Similar approaches have been taken by northern cities Detroit and Cleveland.

Immigration from Central America into México plummets, FOX News Latino, 10/11/11
Mexican government official cites extortion, kidnapping, and disappearances as the reason for the dramatic decrease in immigration into Mexico. Since 2005, unauthorized immigration has dropped from 433,000 a year in 2005 to 140,000 in 2010.