This blog is part of a series to highlight the dangers of repealing the Affordable Care Act. Multiple times a week, Community Catalyst will highlight a different constituency to draw attention to the benefits the ACA has afforded them and to outline what a loss of coverage would mean.

Following the election of Donald Trump, immigrant communities have grown increasingly anxious about their safety and well-being. The president-elect’s hard-lined stance on anti-immigrant policies has stoked fear among undocumented immigrants and further heightened concerns about discrimination, families being separated, job security and access to health care for millions of people.

The ACA has significantly increased access to affordable health coverage for lawfully present immigrants through Medicaid expansion and health insurance Marketplaces with tax credit subsidies. For example, from 2013 to 2014, the percent of noncitizens with health care coverage jumped by 6.3 percent.

Percent Insured by Citizenship

Image Attribution: Screenshot taken from on 1/11/2017

The Affordable Care Act was built upon the success of extending (or lifting) five-year coverage to children and pregnant women through CHIPRA. In 2009, Congress Reauthorized the Children’s Health Insurance Program (CHIP), including the Legal Immigrant Children’s Health Improvement Act (ICHIA) provision allowing states the option to lift the five-year waiting period for lawfully present immigrants to enroll in Medicaid coverage. States such as Ohio, Utah and Florida recently adopted ICHIA to extend health coverage to immigrant children and pregnant women. This coverage option was critically important in ensuring that low-income immigrant women have healthy pregnancies and healthy babies. While recipients of the Deferred Action for Childhood Arrival’s (DACA) program were excluded from the Affordable Care Act’s coverage options, some states took an additional step to extend health coverage to undocumented immigrants. California, for example, deemed DACA recipients eligible for Medicaid coverage under Permanently Residing in the United States Under Color of Law (PRUCOL). The president-elect’s stance on programs benefitting immigrant communities sends a troubling signal about potential cuts and changes impacting immigrant families.

The upcoming debate around refunding CHIP should ensure that advocates maintain current eligibility criteria so that immigrant families and children continue to access the care they need. The push for Medicaid block grants and per capita caps threatens to lessen federal dollars going into states to support immigrant health programs. The movement to end programs benefitting DACA recipients and other groups under PRUCOL is yet another challenge. It’s no surprise that immigration lawyers, for example, have reported seeing a ten-fold increase in calls from immigrant clients concerned about what Donald Trump’s election means for their families. 

Consumer health, immigrant and social justice advocates can play an active role in protecting immigrants at risk of losing available health coverage options. Identify whether your state has taken up the ICHIA option. Continue educating and informing immigrant communities about available health care options and protections at local enrollment and community events. Determine how your organization can complement ongoing initiatives to educate and inform immigrants about their rights and protections. Highlight the ACA’s role in improving health care access within immigrant communities. Identify, collect and elevate the stories of immigrants whose lives have been improved by the ACA. Explore ways to partner with local groups reaching immigrant populations to support immigrant families, foster productive partnerships and further elevate the importance of the ACA for diverse constituencies across the country. All of this will go a long way for advocates to serve as a strong, vocal ally for protecting immigrant communities and their health coverage.