Earlier this year, we summarized a number of state victories achieved throughout 2021 to expand health care access to immigrant communities across the country. Some of the 2021 successes have recently gone into effect or will begin on January 1, 2023. With the Open Enrollment period beginning on November 1, this is a prime opportunity for advocates and community organizations, in partnership with navigators and assistors, to do outreach within their communities on new healthcare opportunities for immigrants in their state.

In our latest New Mexico case study and Illinois addendum, state partners share their efforts and insights regarding their state victories. Partners share how they have informed community members about new coverage options for immigrants in their respective states —and the Illinois addendum contributes a rich analysis on the grassroots mobilization that led to their successful enrollment rates.

Akin to 2021, state organizers and advocates continued to push for legislative, budgetary, and administrative changes throughout 2022 to reduce healthcare disparities among immigrant communities.

The following states have made progress toward improving immigrants’ access to health care in 2022:

  • California will begin to offer Medicaid-like coverage for immigrant adults 26 to 49 years old by January 2024.
  • Colorado passed legislation that will provide comprehensive Medicaid-like coverage for immigrant children and pregnant people (prenatal and 12months postpartum) regardless of their immigration status beginning in January 2025.
  • Connecticut increased the age from eight to 12 for their Medicaid-like program going into effect on January 1, 2023. Immigrant children enrolled before to their 13th birthday can be grandfathered into the program as long as they continue to meet eligibility requirements.
  • Illinois expanded the Health Benefit for Immigrant Adults (HBIA) program to immigrant adults between the ages of 42 to 54 and began enrollment on July 1, 2022.
  • Maine’s supplemental budget included the implementation of preventative oral health services in all schools in the state by January 2025. Services will be available to school children regardless of immigration status.
  • Maryland passed the Healthy Babies Equity Act, which will provide Medicaid-like coverage for pregnant people, regardless of their immigration status, and their child(ren) up to the age of 1 year old.
  • New York authorized Medicaid-like coverage for undocumented adults who are 65 and older and for pregnant people, including prenatal and 12-months postpartum coverage.
  • Rhode Island passed comprehensive Medicaid-like coverage to all income-eligible children regardless of their immigration status.
  • Washington state passed a supplemental budget appropriating funds to implement a Medicaid-like program for immigrants up to 138 percent FPL by 2024. Washington also submitted a 1332 waiver and may soon become the first state to receive approval to bypass immigration documentation requirements to enroll for Marketplace plans.

Despite these victories, fears and caution remains high among immigrants

Despite these victories, the public charge chilling effect continues to prohibit immigrant families from enrolling in existing or new benefits they qualify for, in fear of being denied admission or residency in the United States. The new, final public charge rule goes into effect on December 23, 2022, and clarifies that immigrants can access health, nutritional, and housing benefits they are entitled to without fear of consequences to their or a family member’s immigration status. This clarification is critical and reassures that access to these state-funded health benefits is safe to enroll in without the risk of becoming a public charge.

Furthermore, these victories are evidence of how states continue to take charge in reducing health care disparities, yet gaps will remain without federal action. Recently Members of Congress sent a letter to HHS Secretary Becerra, requesting that ACA eligibility be modified to include DACA recipients and no longer deny them health care benefits. The passage of policies like the HEAL Act and LIFT the BAR Act would also complement state victories and is key to achieving health justice.

The consensus is clear — we need to eliminate barriers to health care for everyone, regardless of their immigration status. We look forward to seeing the achievements of our state partners throughout 2023 to make health care more equitable for immigrants and their families at the state and federal levels.