Immigration reform 2013

1. Immigration reform 2013 Jenny Rejeske Health Policy Analyst rejeske@nilc.org April 28, 2013

2. Agenda • Why Immigration Reform? • Prospects for Immigration Reform in 2013 • Status of Immigration Reform Efforts • Access to Health Care & Economic Supports • Advocacy tips

3. Why Immigration Reform? • First time since Immigration Reform and Control Act of 1986 • Status quo is not an option • 11+ million undocumented immigrants • 1+ million undocumented children; 4.5 million US citizen children living with undocumented parent • 1+ million DREAM Act eligible young people • 11 million in shadows, underclass • High rates of employment – most in retail, service, personal care, construction, manufacturing, landscaping • Disproportionately low-income

4. Why Immigration Reform? • Record enforcement • Record deportations – 400,000/yr, 1100/day • Lack of due process protections • No Miranda warning • No right to lawyer if you can’t afford one • No right to speedy trial • No right to trial before jury

5. Why Immigration Reform? • Access to health care & economic supports • Legal barriers – for most public benefits, must be in a “qualified” immigrant category (lawful permanent resident [LPR, green card] or humanitarian immigrant). Most must wait 5 years. • Affordable Care Act (ACA) – “lawfully present” – LPRs, applicants for LPR, humanitarian immigrants, employment/student visas, TPS, deferred action (except DACA), work authorized • Fear factors • Public Charge – concern that use of health care, government assistance will jeopardize immigration process • Language barriers • Reporting to immigration officials • Complexity  confusion

6. Access to health care & economic supports cont. • Consequences • Disproportionately high uninsurance rates • Undocumented adults 3+ x more likely to lack insurance • Undocumented children 7x more likely to lack insurance • Health access outcomes – • Avoid, delay care until can’t • Less likely to have a doctor, seek preventive care

7. Prospects for Immigration Reform in 2013 – What’s Changed? • Bigger, more diverse movement • Demographics shift • Public opinion shift – support path to legalization rather than mass deportation – see link • Support for access to government assistance with health insurance – see link • The ELECTION – record numbers of Latinos, Asian & Pacific Islanders, immigrants voting for President Obama

8. What’s Happening Now? • White House • Senate • Gang of 8 – Schumer (NY), Durbin (IL), Menendez (NJ), Bennet (CO), McCain (AZ), Graham (SC), Flake (AZ), Rubio (FL) • Border Security, Economic Opportunity, and Immigration Modernization Act of 2013 – S. 744 • Mark-up – consideration of amendments starting 5/9 • Floor consideration in June

9. Senate Judiciary Committee • Feinstein (CA) • Schumer (NY) • Durbin (IL) • Whitehouse (RI) • Klobuchar (MN) • Franken (MN) • Coons (DE) • Blumenthal (CT • Hirono (HI) • Grassley (IA) • Hatch (UT) • Sessions (AL) • Graham (SC) • Cornyn (TX) • Lee (UT) • Cruz (TX) • Flake (AZ)

10. S. 744 Overview • Registered Provisional Immigrant status (RPI) • Blue card status (agricultural workers) • V nonimmigrant visas (approved family petition) • W visas (new agricultural program, other low-skilled workers) • Expansion of high-skilled visas • Family-based  Merit based • Mandatory employment verification with worker’s protections • Increased enforcement with due process protections

11. “Road to Citizenship" • Total: • 13 years • $3750 + fees

12. S. 744 – Access to Health Care & Economic Supports • Excluded from federal means-tested public benefits (Medicaid, CHIP, SNAP, TANF, SSI) • Restricted to qualified immigrants, still • Specifically barred – RPIs, blue cards, Vs • ACA • RPIs, blue cards, Vs “lawfully present” but excluded from premium tax credits & cost-sharing reductions • Eligible for full-price health insurance in Exchanges/Marketplaces • Subject to individual mandate unless eligible for exemption • Other lawfully present immigrants remain eligible, including H-visa categories and W visas

13. House of Representatives • Gang of 8 – Lofgren (CA), Gutierrez (IL), Becerra (CA), Yarmuth (KY), Diaz-Balart (FL), Labrador (ID), Sam Johnson (TX), John Carter (TX) • Piecemeal or comprehensive bill? • House Judiciary Committee -http://judiciary.house.gov/about/members.html

14. Challenges & Outlook • Cost • Politics • Benefits • ACA • Budget context – sequester, tax reform, deficit reduction, debt ceiling • Short term – push as hard as we can for coverage for all kids, elimination of 5-yr bar, eligibility for ACA subsidies  create political space • May be opportunities for kids • Hang on to current eligibility levels • Long term – change conversation from exclusion to rational

15. Tips for Advocacy • Personal Stories – illustrate the diversity, humanity, same as everyone else • Importance of insurance • Consequences of no access to insurance or health care • Positive stories • Voice of providers crucial

16. Contact Info Jenny Rejeske Health Policy Analyst National Immigration Law Center 1444 I St NW, Suite 1110 Washington, DC 20005 (202) 683-1994 rejeske@nilc.org www.nilc.org http://nilc.org/immreform2013.html