Federal and State Policies Supporting Healthcare Access for Undocumented Immigrants

A critical federal policy that aligns with the advocacy priority of expanding healthcare access for undocumented immigrants is the Health Equity and Access under the Law (HEAL) for Immigrant Families Act of 2023 (H.R. 519). This bill suggests eliminating the five-year waiting period for lawful permanent residents to access Medicaid and allows immigrants who are undocumented to have health coverage in the Affordable Care Act market (Alarcon, 2022):Federal and State Policies Supporting Healthcare Access for Undocumented Immigrants.

This policy is directly aligned with the need to eliminate structural barriers that contribute to health disparities. The bill’s strength lies in its inclusive scope and potential to improve public health outcomes. However, its major weakness is the strong political opposition in Congress, which limits its likelihood of enactment. To improve its feasibility, bipartisan strategies and economic framing—such as demonstrating healthcare cost savings—may help shift public and legislative support.

At the state level, California’s expansion of Medi-Cal to include low-income residents regardless of immigration status serves as a model for equitable healthcare reform. By January 2024, all ages of undocumented immigrants can have full-scope Medi-Cal benefits (Cha et al., 2023). This aligns closely with the advocacy priorities by ensuring access to preventive and primary care, reducing emergency visits, and addressing chronic conditions early.

Its strongest point is feasibility and immediate effect on the population. Nevertheless, sustainability and scalability in funding are considered a weakness, particularly in states with varying political environments. Less resourceful or less open immigration states may oppose a comparable alteration, which further indicates the necessity of federal instructions and support (Young et al., 2023).

These policies are beneficial to vulnerable immigrant groups as they allow them to recognize healthcare as a human right rather than the privilege of citizenship. The HEAL Act and California Medi-Cal reform represent steps in the right direction in order to dissolve the problems currently caused by highly unbalanced systems. To attain equitable access to healthcare without fear or discrimination for undocumented immigrants across the country, such initiatives need to be replicated broadly at the federal level.

References

Alarcon, F. J. (2022). The migrant crisis and access to health care. Delaware Journal of Public Health, 8(4), 20–25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9621574/#:~:text=Chronic%20conditions%20like%20diabetes%2C%20high

Cha, P., Heintzman, J., & Malagon, P. (2023, October). Health conditions and health care among California’s undocumented immigrants. Public Policy Institute of California. https://www.ppic.org/publication/health-conditions-and-health-care-among-californias-undocumented-immigrants/

Young, T., Tafolla, S., & Perez-Lua, F. (2023). Caught between a well‐intentioned state and a hostile federal system: Local implementation of inclusive immigrant policies. The Milbank Quarterly, 89(79). https://doi.org/10.1111/1468-0009.12671

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Policy
What are legislators currently doing to address your selected advocacy priorities for a vulnerable population? Are there current policies in place? Are there current policies proposed at either the state or federal level?

What are the most obvious strengths and weaknesses of these policies as they relate to your advocacy priority? What might need to change?

For this Discussion, you will identify a state or federal policy that aligns with your advocacy priority. After identifying the policy, you will consider how the policy aligns and supports your identified vulnerable population. How and why does this policy align with your advocacy priorities?

To Prepare:

• Review resources related to health policy.
• Consider the health policy that might align with your advocacy priorities.

By Day 3 of Week 5
Post a response detailing the following:

• Identify a proposed state and federal policy that aligns with your advocacy priorities for your vulnerable population. Clearly describe and provide evidence to support this policy. If the policy needs to change, describe and provide evidence to support the proposed change.