A National Perspective: The Health Reform Law Does Not Apply Equally to All Immigrants

In March 2010, the landmark Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 were signed into law. This historic law recognizes the impact of disparities in health status and access to care among vulnerable populations in the U.S. It prioritizes the reduction of these disparities and advancement of health equity among such populations.

However, the health reform law does not apply equally to all immigrants, especially the undocumented.

Strict guidelines delineate which immigrant populations are eligible to access the new benefits. Many immigrant children, youth and families endure severe and pervasive disparities in health status and outcomes and face barriers to obtaining quality care and services. Over time, their health deteriorates and they experience disproportionate disease burden. Immigrants from the African diaspora, for example, are found to have comparable chronic and infectious disease burdens as African-Americans. This poses challenges to eliminating disparities, and goes against the law's goal of providing universal access to care.

As we approach its fourth anniversary, it is important to understand the implications of the law on health equity. This presentation will discuss the education and advocacy process during health reform negotiations to ensure inclusion of health equity, especially public policies impacting immigrants in the PPACA. It will also discuss applicable provisions of the law with the greatest impact on eliminating disparities and achieving health equity. The current status of these provisions, challenges to implementing them, and opportunities to get involved will also be presented.