Five Years is a Lifetime to Wait for Affordable Health Care
Immigration Matters
New America Media, Editorial, Marielena Hincapié, Posted: Oct 28, 2009
Editor's note: What do the health care proposals being discussed in Congress have in store for legal immigrants? For 30 years, the National Immigration Law Center (NILC) has advocated for the rights of low-income immigrants and their families. One of NILC’s priorities is to increase immigrants’ access to quality and affordable health care by providing extensive policy analysis and advocacy. Marielena Hincapié is Executive Director of NILC. IMMIGRATION MATTERS regularly features the views of immigration advocates.
Let me be candid: health care reform has struck a personal chord. On October 4th, my aunt Margarita died of pneumonia and cancer. After receiving that dreaded call from my sister saying Margarita only had hours to live, I caught the first flight to Rhode Island. On the flight, I could not help but put this in the context of the broader health reform debate.
I shuddered at the thought that had Margarita been in the United States for fewer than five years, she would not have gotten the health care she needed in her final days. Although I am grateful for the care that my aunt received, my heart sinks at the realization that the nation’s 600,000 low-income legal immigrants will continue to wait for too long for affordable health care unless we act today.
Across the country, we are watching health care negotiations in Washington with the hope that Congress will do the right thing and reform a broken system that lets too many Americans fall through the cracks. Under the current proposals, Congress inexplicably restricts low-income legal immigrants from the federal Medicaid and Medicare programs, which provide meaningful access to quality, affordable health care for millions of Americans.
This is a restriction we cannot accept. By keeping legal immigrants out of federal programs, Congress will create a fundamentally unfair and unnecessarily exclusionary health care system. Like Margarita, legal immigrants must overcome many hurdles to immigrate to the United States, under our complex and outdated immigration system. We must create the opportunity for these immigrants to integrate into American society without barriers. Having equal access to affordable health care is one necessary component.
This is personal not just for me but also for everyone who has seen a loved one endure a serious illness. They, too, can attest to the fact that five years is too long for anyone to wait for treatment. Destructive illnesses like cancer will not wait for federal policy to catch up to reality, and leaves many immigrants and their loved ones with inadequate medical care and crippling medical bills. Like other Americans, immigrants facing life and death choices for themselves and their families, as well as medical bankruptcy, wonder what happened to the American dream.
The five-year waiting period for legal immigrants to access affordable health care is not only unfair; it is also widely perceived as poor public health policy: just ask the American Academy of Pediatrics, the American Hospital Association, or any of the countless experts in the medical field who have argued that such restrictions are neither cost-efficient nor effective. Despite all this evidence to the contrary, Congress has yet to eliminate this discriminatory and costly restriction.
Although polls show that the American public supports a repeal of this waiting period, Congress still hasn’t gotten the message. Many in Congress will not stand up for doing what’s right for immigrants without a boisterous public backing, for fear of backlash against them by a small but vocal anti-immigrant minority. It is our duty to remind the people elected to represent us that we expect them to enact a health care system that ensures fair and equal access for our diverse communities.
Earlier this year, President Obama and Congress heard from all of us and determined that five years was indeed too long for lawfully residing immigrant children and pregnant women to wait for access to affordable care. It is now time to do the same for their families.
Anti-immigrant voices should not keep Congress from forgetting what’s really at stake: achieving a meaningful health reform for all Americans. It makes no sense that Margarita’s health care would have depended on when she entered the United States. She and all other legal immigrants comprise a vital economic and social component of our society and they should be treated equally. Just as they did in January, when they voted to remove the waiting period for children and pregnant women, let’s remind Congress that immigrants are a part of the fabric of our society, and by imposing nonsensical limits on their access to health care we go against the very character of our country.
Related Articles:
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Families Torn Apart by Immigration
Health Insurance and Immigration Reform - Separate but Inter-Related
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User Comments
jerseycityjoan on Oct 30, 2009 at 22:57:23 said:
Here's what I found at the government's immigration website about family sponsorship of legal immigrant:
"How Do I File an Affidavit of Support for a Relative?
What is an affidavit of support?
If you are bringing a relative to live permanently in the United States, you must accept legal responsibility for financially supporting this family member. You accept this responsibility and become your relative's sponsor by completing and signing a document called an affidavit of support. This legally enforceable responsibility lasts until your relative becomes a U.S. citizen or can be credited with 40 quarters of work (usually 10 years.)"
These rules are a result of changes in immigration made during the Clinton Administration specifically to make it harder for new legal immigrants to obtain public welfare benefits. These are not new laws or new resentments.
* * *
Here's what an LA Times article from Oct 21, 1997 says:
"Under the new law, sponsors will not be free of financial responsibility until the sponsored immigrants become U.S. citizens, a process that takes at least five years, or until the settlers have worked and paid taxes for 10 years. Otherwise, the support obligation remains in place until the sponsored immigrants die or depart permanently from the United States. Even divorce does not nullify petitioners' legal responsibility to support sponsored spouses.
The scope of immigrant use of benefits is hotly contested, but studies generally show that immigrants--who are almost twice as likely to be living in poverty as U.S. natives--tend to utilize public aid more than the U.S.-born. A recent U.S. Census study found that 5.8% of immigrants receive cash income from public assistance programs, compared with 4.5% of U.S. natives.
Congress last year made immigrants ineligible for most big-ticket federal "means-tested" benefit programs--including food stamps, cash welfare and nonemergency Medicaid, the joint federal-state insurance plan for the poor--during their first five years in the United States. The new rules ensure that noncitizens will remain ineligible beyond that because their sponsors' incomes will be counted when determining eligibility for public aid."
***
Finally, I checked on what is required to be a sponsor. The answer is, financially, very little: the minimum requirement is a mere 125% of poverty level, so that a family of three who sponsors two overseas relatives would only have to have about $36,000 (and it can be combination of earnings and assets, so the family would not even have to have an annual earned income of $36,000, it could be less).
It seems to me these financial guidelines are unreasonably low. It's pretty clear that a family living at 125% of poverty doesn't have the assets to cover their relatives if they get into financial trouble.
But why should the answer be to stick the U.S. taxpayers with the expense? Why shouldn't we just increase the financial requirements to be a sponsor for anyone who isn't a minor child or a spouse?
Mary de G on Oct 30, 2009 at 11:21:48 said:
Yes, the 5-year waiting period should be abolished.
I was born here. When I got out of college & began to work, there was a period when I was paying into the Social Security system but was not entitled to draw benefits because I hadn't worked long enough. The idea was that I'd be young & healthy, and in case of need my family would have to help.
Now I'm middle-aged, and I've sponsored 2 of my stepkids for green cards. They're here now. Let me be clear that they are **legal** immigrants; getting them here took thousands of dollars and years of waiting.
While we've been waiting, my state (Mass) put in place a requirement for everyone to have health insurance. I applaud, in principle. Also while we were waiting, the kids went from minors who could have been covered under our family plan, to young adults who cannot be. And also while we were waiting, the economy took a nosedive, and Mass. cut new legal immigrants out of their state-sponsored health plan.
These young people aren't US citizens **yet** because they can't be. They have to wait a minimum of 5 years before they can apply for citizenship. To treat them as "foreign nationals" during this time strikes me as unfair and unreasonable.
They're not just forbidden to draw on SSI or SSDI, as I was at their age. They're not allowed to have unemployment, disability, affordable health care -- any government-backed benefit except Workers Comp (God forbid!) and emergency medical care is forbidden. And before you recommend private insurance, let me remind you how much it costs ... We passed the financial requirements for sponsoring immigrants, but we aren't made out of money.
This is what we get for following the rules and doing everything right. New immigrants are seen as a soft target because they can't vote -- yet. These 2 have a citizen stepparent who is busy making a civics lesson out of this situation, and remembering who voted how. In 5 years, they'll be taking this into account.
JerseyCity Joan said: "Yet I never hear of people sending aid money to Mexican nonprofit and political reform groups. Why is that?" I expect you never hear about such things because you don't listen for them. We do, and most immigrant familes do.
commonsense on Oct 30, 2009 at 11:12:04 said:
We're the world's only superpower. Why would we deny health care to part of the population that makes us who we are? Congress should repeal this ridiculous waiting period.
Jim Williams on Oct 29, 2009 at 17:49:39 said:
Just one more bleeding heart liberal that want me to pay for my health care and someone else that has not earned it by being an american. JUST SAY NO!!
Jim Williams on Oct 29, 2009 at 17:35:45 said:
Just one more bleeding heart liberal that want me to pay for my health care and someone else that has not earned it by being an american. JUST SAY NO!!
CarpeDiem on Oct 29, 2009 at 15:27:55 said:
5 years is too long for ANYONE to wait for health care. These are immigrants who have gone through our crazy and broken immigration system, met all our requirements, and want to be part of this country. It makes no sense to deny them health care especially if they're going to have to have health insurance like everyone else. We need to stop complaining about all the reasons we can't do something and find good solutions to fix both the immigration as well as the health care system. Denying people health care fixes neither problem and only make the health care system and our country worse off. Congress should do the right thing and eliminate the 5 year waiting period NOW!
Isabel Alegria on Oct 29, 2009 at 09:21:33 said:
The negative comments to this thoughtful piece skirt the main issue here -- that lawful immigrants pay into the system and under the current 5 yr restrictive policy, don't get what their taxes pay for -- a safety net in times of trouble. Those who say they have nothing against people "who play by the rules" are fast to set conditions when given the slightest opportunity. You can't have it both ways.
jerseycityjoan on Oct 28, 2009 at 22:31:11 said:
I have to say that I found "nativesayno' made many valid points.
The #1 consideration for other countries around the world when making decisions about immigration is what is best for the country. For the past 25 years, many people have come to believe that the U.S. exists to serve the needs of immigrants, both legal and illegal.
When legal immigrants are admitted due to family ties, their sponsoring family member is supposed to provide financial support, yet that seems to be forgotten. I understand that health insurance and health care is expensive, but then so is shifting the cost of covering hundreds of thousands of people to the U.S. taxpayer.
People might look more favorably about easing regulations on the legal immigrants if they weren't so worried about the effects of illegal immigration.
The smartest thing legal immigrant advocates could do would be to take a stand against all the special favors and demands made on behalf of illegal immigrants.
I would also suggest that Americas who wish to help people overseas support change in that country. The solution cannot be to bring every poor person on Earth to the U.S.
Mexico, for example, is a country where the privileged few dominate. While there are many poor Mexicans, Mexico as a country is a top 15 country in terms of wealth.
Yet I never hear of people sending aid money to Mexican nonprofit and political reform groups.
Why is that?
justin on Oct 28, 2009 at 21:32:14 said:
There is only so much money to go around. The issue has been reducing cost more than covering everyone. That\'s what businesses what, that\'s what Americans want. Care will have to be rationed. It\'s a hard pill to swallow, but that\'s the reality.
It\'s a lot easier to the government to restrict recent immigrants than to cut Medicare for American seniors. The GOP would have a field day in 2010 if Obama cut the care for the so-called \"Greatest Generation\" so recent immigrants can be cared for. Congress is going to get the voters opinion of these reforms in 2010, recent immigrants aren\'t going to matter, the Democrats don\'t want this to turn out like 1996. That\'s the political reality.
nativessayyes on Oct 28, 2009 at 14:31:03 said:
I'm a native born US citizen, and I agree that Congress should end the unfair 5-year waiting period that prevents legal immigrants from using Medicaid.
These immigrants pay the exact same taxes as citizens, and it's unfair for the government to grant them green cards, collect their taxes, and then leave them without Medicaid if they fall on hard times. It's only a guess, but I don't nativessayno would be happy if s/he was left out of a program her/his taxes paid for.
I want health reform to allow more of my neighbors and coworkers to have health insurance they can afford. Here's a suggestion for nativessayno: take a few deep breaths and read the editorial again - it clearly is calling for an end to forcing legal immigrants to wait 5 years for Medicaid. This isn't controversial, it's common sense, and it's consistent with an American value - fairness.
nativessayno on Oct 28, 2009 at 12:07:08 said:
My condolences for the loss of one's aunt. However, unitentionally or intentionally personal loss and immigrant healthcare rights are conflated here.
You state: This is a restriction we cannot accept. Who is the "we" you cite? The 75% of US citizens that wish to curtail and restrict illegal immigration?
You may have noticed MANY MANY US citizens are suffering.....I don't see immigrants excersing great consideration or empathy for them whatsoever!!!!!!
You also state: This is personal not just for me but also for everyone who has seen a loved one endure a serious illness. Of course it is awful to witness a loved one suffer or to lose them.....but you leap to the conclusion that immigrants should be provided health benefits EQUAL to US citizens. WHY on earth do they merit this? And why on earth do I gotta pay for them?
" Many in Congress will not stand up for doing what’s right for immigrants without a boisterous (ha) public backing, for fear of backlash (backlash?) against them by a small but vocal anti-immigrant minority." BOISTEROUS? An absurd, patronizing and belittling assesment. Again, are you citing ONLY legal immigrants? Maybe you are mixing the two groups to plead/demand what citizen are eligable for...just a little? What about the rights of your so-called small but vocal anti-immigrant minority (*actually 75%)? I suppose we have no more say in the matters within our own country anymore; especially if newcomers say so.
The author gives the impression that she cares mainly about Latino immigrant groups much more than Americans; she expect our congress to do THEIR bidding why? With the logic of this article; because one suffers when they are ill........ergo.... citizens pay for 20M low-income foreign national's heathcare??? Gee, I beg to differ! You expect congress to do the right thing and hand over the "goods" to foreign nationals -guess what?...YOU are in the minority opinion. But again, you were very unclear (by design?) about which "immigrants" you were citing...legal or not legal, or both??
Suffering the loss of an aunt and making demands of US citizens to pay for immigrant health care.....they are related, how? "Go against the very character of our country"? You mean to break into our country and job-force during critical financial turmoil for us, character like that? OH, I forgot it is ALL about immigrants ALL the time now. Pardon me, I thought citizens actually matter....guess not if you say others are far more meaningful now and citizens are just exclusively necessary for PAYING for everything but nothing else.
You expect congress to do the right thing and hand over the "goods" to foreign nationals -guess what?...YOU are in the minority opinion. But again, you were very unclear (by design?) about which "immigrants" you were citing...legal or not legal, or both??
What about the rights of your so-called small but vocal anti-immigrant minority (*actually 75%)? I suppose we have no more say in the matters within our own country anymore; especially if newcomers say so. Funny, this is something I can not accept!
readwithcare on Oct 28, 2009 at 11:07:49 said:
Making people wait five years for health care is un-American!
-->Continuing this politically-motivated policy is bad for health, and will undermine health care reform, which is all about the idea that when people get the preventative care they need, when they need it, we can drive down costs in our medical system.
Congress should eliminate the 5 year waiting period today.