Letter from Richard David:
Dear Friends -
Of all the dissapointments of this year’s health reform legislation, maybe the most politically destructive was the intentional exclusion of undocumented immigrants. They can’t even BUY health insurance in the exchanges! This concession to xenophobia is dangerous. Nationalist sentiment and attacks on minoroties in a time of economic crisis and ever expanding wars is not just another political trend. It is a particularly ugly and dangerous direction for American politics.
Michael Lyon, from California, drafted a late-breaker resolution to oppose the exclusion of immigrants from health reform. It is pasted in below. Please support this effort to put APHA on record on this issue.
Building multi-racial support for Latinos and other immigrants is urgently needed. If you want to help build support for this policy statement, please get in touch now or in Denver and we will coordinate our efforts. We need to have copies circulated in every business meeting and scientific session. People should stand up and speak out on this issue in every possible forum.
Opposing the Exclusion of Undocumented Immigrants from Health Care Reform
The American Public Health Association,
Noting that the Obama Health Plan, The Patient Protection and Affordable Care Act (PPACA), not only leaves at least 23 million uninsured[i], but it explicitly excludes ALL undocumented immigrants,[ii] and,
Noting that the PPACA even forbids undocumented immigrants from using their own money to buy health insurance at discounted prices through the exchanges,[iii] and,
Noting that, as a group, undocumented immigrants have arguably the greatest need of having healthcare expanded to them because:
FIRST: Undocumented immigrants are twice as likely to be uninsured as documented immigrants,[iv] and,
SECOND: Undocumented immigrants are excluded from Medicaid and SCHIP[v] by federal law, and,
THIRD: Undocumented immigrants’ future access to healthcare will be more challenging because (1) increasing raids[vi] and deportations[vii], and the Secure Communities Initiative[viii] make undocumented immigrants fearful of being visible, (2) State and County budget cuts are eliminating health services for undocumented immigrants[ix], (3) Anti-immigrant groups are pressing jurisdictions to withdraw health services from undocumented immigrants[x], and (4) Legislators are even at the point of considering withdrawing citizenship from US born children of undocumented immigrants, contravening a 150-year old constitutional right,[xi] and,
FOURTH: Many of the factors contributing to poor health indicators for immigrants in general are worse for undocumented immigrants, such as immigrants’ fears of presenting to health institutions, immigrants’ increasing unemployment rates and the higher cost of buying individual insurance, and health institutions’ fear of losing funding for treating immigrants. Even among the insured, immigrants’ and their children’s access to ambulatory and emergency care is worse than that of citizens,[xii] and,
Noting that measures taken to deny healthcare to undocumented immigrants result in citizens losing healthcare also, as exemplified by the 2004 cancellation of Colorado’s Presumptive (Medicaid) Eligibility program, which had allowed pregnant women to receive prenatal care while their Medicaid applications were processed. The entire program was eliminated because about half of the women were later found to be ineligible by immigration status. Citizen and immigrant women alike were put at risk, as well as their unborn children.[xiii]
And finally, noting that APHA has taken a clear positions against withholding medical care from undocumented immigrants in its resolution 2001-23, which “Urges the President and the Congress to oppose denial of eligibility for programs providing nutritional, prenatal, public health, medical care, and behavioral health benefits and services to any person residing in the United States on the basis of her or his immigration status”, [xiv] its resolution 9501, which “Opposes any mandates and initiatives that would limit access to public health interventions and health services for undocumented and documented immigrants and their children.”[xv] and its resolution LB04-07, which “Deplores and warns against measures curtailing, eliminating, or disrupting health care to undocumented immigrants.”[xvi]
Therefore, the American Public Health Association
Directs its Executive Leadership to communicate to the President, Congress, and media APHA’s opposition to the exclusion of healthcare for undocumented immigrants from Health Reform legislation, and
Directs its Executive Leadership to communicate to the President, Congress, and media APHA’s support of health reform that provides equal, comprehensive, affordable, accessible healthcare for everyone, regardless of status of health, employment, income, or legalization, that is, Single-Payer Healthcare, and
Directs its Executive Leadership to communicate to the President, Congress, and media APHA’s demand that community health centers receiving $11 billion of dollars of federal aid over the next five years through the PPACA[xvii] give undocumented immigrants comprehensive health care, and
Encourages its members and Affiliates to attend future events on immigration reform (public rallies, demonstrations, press conferences and the like) with the demand of comprehensive, affordable, accessible medical care for all immigrants, regardless of legalization status.
[iv] Pew Hispanic Center, “Hispanics, Health Insurance and Health Care Access” http://pewresearch.org/pubs/1356/hispanics-health-insurance-health-care-access ,September 25, 2009, (Accessed Oct. 3, 2010),
Working Immigrants, “Health uninsured rates among immigrants: far higher,” http://www.workingimmigrants.com/2009/08/health_uninsured_rates_among_i.html, August 19, 2009, (Accessed Oct. 3, 2010).
[ix] New York Times, “Reprieve Eases Medical Crisis for Illegal Immigrants,” http://www.nytimes.com/2010/01/06/us/06grady.html, January 6, 2010, (Accessed Oct. 3, 2010),
Kaiser Daily Health Policy Report, “Economic Recession Forcing Local Health Departments To Reduce Services to Undocumented Immigrants,” http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=57497, March 16, 2009, (Accessed Oct. 3, 2010),
New York Times, “Immigrants Facing Deportation by U.S. Hospitals,” http://www.nytimes.com/2008/08/03/us/03deport.html?_r=1&hp=&pagewanted=all, August 3, 2008, (Accessed Oct. 3, 2010)
[xi] Newsweek Magazine, “The Next Front on Immigration,” http://www.newsweek.com/2010/08/01/the-next-front-on-immigration.html, August 1, 2010, (Accessed Oct. 3, 2010),
Politico, “John McCain backs citizenship hearings,” http://www.politico.com/news/stories/0810/40589.html, August 4, 2010, (Accessed Oct. 3, 2010).
Filed under: global health, immigrants, Media, Policy, public health, Urgent