,,ii #aafth ,,congress #b;d ,session ,s4 #cgii ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ba1 #bjbj,mr4 ,booker introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to expand access to health care services1 including sexual1 reproductive1 and maternal health services1 for immigrants by removing legal and policy barriers to health insurance coverage1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,health ,equity and ,access under the ,law for ,immigrant ,women and ,families ,act of #bjbj or as the ,,heal for ,immigrant ,women and ,families ,act of #bjbj4 #b4 ,findings2 purpose 7a7 ,findings ,congress finds as follows3 7#a7 ,health insurance coverage reduces harmful disparities by alleviating cost barriers to and increasing utilization of necessary health care services1 especially among low-income and underserved populations1 including women4 7#b7 ,based solely on their immigration status1 many immigrants and their families face legal and policy restrictions on their ability to obtain affordable health insurance coverage through ,medicaid1 the ,children's ,health ,insurance ,program 7,,chip71 and the health insurance exchanges4 7#c7 ,lack of health insurance coverage contributes to persistent disparities in the prevention1 diagnosis1 and treatment of negative health outcomes experienced by immigrants and their families4 7#d7 ,nearly half of immigrant women are of reproductive age4 ,immigrant women are also disproportionately living in low-income households and lacking health insurance coverage4 ,legal and policy barriers to affordable health insurance coverage therefore particularly exacerbate their risk of negative sexual1 reproductive1 and maternal health outcomes1 with lasting health and economic consequences for immigrant women1 their families1 and society as a whole4 7#e7 ,denying health insurance coverage or imposing waiting periods for health insurance coverage unfairly hinders the ability of immigrants to attain good health and undermines the economic well-being of their families4 7#f7 ,the population of immigrant families in the ,united ,states is expected to continue to grow4 ,one in seven ,united ,states residents is foreign-born1 and approximately one in four children in the ,united ,states has at least one immigrant parent4 ,it is therefore in the ,nation's shared public health and economic interest to remove legal and policy barriers to affordable health insurance coverage based on immigration status4 7#g7 ,although ,deferred ,action for ,childhood ,arrivals 7,,daca7 recipients are authorized to live and work in the ,united ,states1 they have been unfairly excluded from the definition of lawfully present and lawfully residing for purposes of health insurance coverage through the ,department of ,health and ,human ,services1 including ,medicaid and ,,chip1 and the health insurance exchanges4 7#h7 ,immigration law is constantly evolving and new immigration categories for individuals with federally authorized presence in the ,united ,states may be created4 7b7 ,purpose ,it is the purpose of this ,act to-- 7#a7 ensure that all individuals who are lawfully present in the ,united ,states are eligible for all federally funded health care programs2 and 7#b7 advance the ability of undocumented individuals to obtain health insurance coverage through the health insurance exchanges4 #c4 ,removing barriers to health coverage for lawfully present individuals 7a7 ,medicaid ,section #aijc7v77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7v77#d77 is amended-- 7#a7 by amending subparagraph 7,a7 to read as follows3 7,a7 ,notwithstanding sections #dja7;a71 #djb7;b71 #djc1 and #dba of the ,personal ,responsibility and ,work ,opportunity ,reconciliation ,act of #aiif1 payment shall be made under this section for care and services that are furnished to individuals who are not citizens of the ,united ,states1 including aliens described in paragraph 7#a71 if they otherwise meet the eligibility requirements for medical assistance under the ,state plan approved under this title 7other than the requirement of the receipt of aid or assistance under title ,,iv1 supplemental security income benefits under title ,,xvi1 or a ,state supplementary payment7 and are lawfully present in the ,united ,states 7including such an individual who is granted deferred action or other federally authorized presence74 2 7#b7 in subparagraph 7,b7-- 7,a7 by striking a ,state that has elected to provide medical assistance to a category of aliens under subparagraph 7,a7 and inserting individuals provided medical assistance pursuant to subparagraph 7,a72 and 7,b7 by striking such an alien on the basis of provision of assistance to such category and inserting such an individual on the basis of provision of assistance to such individual2 and 7#c7 in subparagraph 7,c7-- 7,a7 by striking an election by the ,state under subparagraph 7,a7 and inserting the application of subparagraph 7,a72 7,b7 by inserting or be lawfully present after lawfully reside2 and 7,c7 by inserting or present after lawfully residing each place it appears4 7b7 ,,chip ,subparagraph 7,n7 of section #bajg7;e77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is amended to read as follows3 7,n7 ,paragraph 7#d7 of section #aijc7v7 7relating to lawfully present individuals74 4 7c7 ,effective date 7#a7 ,in general ,except as provided in paragraph 7#b71 the amendments made by this section shall take effect on the date of enactment of this ,act and shall apply to services furnished on or after the date that is #ij days after such date of enactment4 7#b7 ,exception if ,state legislation required ,in the case of a ,state plan for medical assistance under title ,,xix1 or a ,state child health plan under title ,,xxi1 of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by the amendments made by this section1 the respective ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of such session shall be deemed to be a separate regular session of the ,state legislature4 #d4 ,consistency in health insurance coverage for individuals with federally authorized presence1 including deferred action 7a7 ,in general ,for purposes of eligibility under any of the provisions described in subsection 7b71 all individuals granted federally authorized presence in the ,united ,states shall be considered to be lawfully present in the ,united ,states4 7b7 ,provisions described ,the provisions described in this subsection are the following3 7#a7 ,exchange eligibility ,section #acaa of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca74 7#b7 ,reduced cost-sharing eligibility ,section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga74 7#c7 ,premium subsidy eligibility ,section #cf;,b of the ,internal ,revenue ,code of #aihf 7#bf ,u4,s4,c4 #cf;,b74 7#d7 ,medicaid and ,,chip eligibility ,titles ,,xix and ,,xxi of the ,social ,security ,act1 including under section #aijc7v7 of such ,act 7#db ,u4,s4,c4 #acif;b7v774 7c7 ,effective date 7#a7 ,in general ,subsection 7a7 shall take effect on the date of enactment of this ,act4 7#b7 ,transition through special enrollment period ,in the case of an individual described in subsection 7a7 who1 before the first day of the first annual open enrollment period under subparagraph 7,b7 of section #acaa7;c77#f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77#f77 beginning after the date of enactment of this ,act1 is granted federally authorized presence in the ,united ,states and who1 as a result of such subsection1 qualifies for a subsidy under a provision described in paragraph 7#b7 or 7#c7 of subsection 7b71 the ,secretary of ,health and ,human ,services shall establish a special enrollment period under subparagraph 7,c7 of such section #acaa7;c77#f7 during which such individual may enroll in qualified health plans through ,exchanges under title ,i of the ,patient ,protection and ,affordable ,care ,act and qualify for such a subsidy4 ,for such an individual who has been granted federally authorized presence in the ,united ,states as of the date of enactment of this ,act1 such special enrollment period shall begin not later than #ij days after such date of enactment4 ,nothing in this paragraph shall be construed as affecting the authority of the ,secretary to establish additional special enrollment periods under such subparagraph 7,c74 #e4 ,removing citizenship and immigration barriers to access to affordable health care under the ,,aca 7a7 ,in general 7#a7 ,premium tax credits ,section #cf;,b of the ,internal ,revenue ,code of #aihf is amended-- 7,a7 in subsection 7c77#a77;,b7-- 7i7 by amending the heading to read as follows3 ,special rule for certain individuals ineligible for ,medicaid due to status2 and 7ii7 in clause 7ii71 by striking lawfully present in the ,united ,states1 but and inserting who2 and 7,b7 by striking subsection 7e74 7#b7 ,cost-sharing reductions ,section #adjb of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjga7 is amended by striking subsection 7e7 and redesignating subsection 7f7 as subsection 7e74 7#c7 ,basic health program eligibility ,section #acca7;e77#a77;,b7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjea7;e77#a77;,b77 is amended by striking lawfully present in the ,united ,states14 7#d7 ,restrictions on ,federal payments ,section #adab of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjhb7 is amended by striking subsection 7d7 and redesignating subsection 7e7 as subsection 7d74 7#e7 ,requirement to maintain minimum essential coverage ,subsection 7d7 of section #ejjj;,a of the ,internal ,revenue ,code of #aihf is amended by striking paragraph 7#c7 and by redesignating paragraph 7#d7 as paragraph 7#c74 7b7 ,conforming amendments 7#a7 ,establishment of program ,section #adaa of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjha7 is amended-- 7,a7 in subsection 7a7-- 7i7 by striking paragraph 7#a72 and 7ii7 redesignating paragraphs 7#b71 7#c71 and 7#d7 as paragraphs 7#a71 7#b71 and 7#c71 respectively2 7,b7 in subsection 7b7-- 7i7 in paragraph 7#a77;,a71 by striking and date of birth and inserting date of birth1 and social security number 7if applicable72 7ii7 by striking paragraph 7#b72 and 7iii7 by redesignating paragraphs 7#c7 through 7#e7 as paragraphs 7#b7 through 7#d71 respectively2 7,c7 in subsection 7c7-- 7i7 by striking paragraph 7#b72 7ii7 in paragraph 7#c71 by striking subsection 7b77#c77;,a7 provided under paragraph 7#c71 7#d71 or 7#e7 and inserting subsection 7b77#b77;,a7 provided under paragraph 7#b71 7#c71 or 7#d72 and 7iii7 by redesignating paragraphs 7#c7 and 7#d7 as paragraphs 7#b7 and 7#c71 respectively2 7,d7 in subsection 7e7-- 7i7 in paragraph 7#a71 by striking subsection 7c77#d7 and inserting subsection 7c77#c72 7ii7 in paragraph 7#b7-- 7,i7 in subparagraph 7,a71 by striking paragraphs 7#a71 7#b71 7#c71 and 7#d7 and inserting paragraphs 7#a71 7#b71 and 7#c72 and 7,,ii7 in subparagraph 7,b71 by striking subsection 7b77#e7 and inserting subsection 7b77#d72 7iii7 by striking paragraph 7#c72 7iv7 by redesignating paragraph 7#d7 as paragraph 7#c72 and 7v7 in paragraph 7#c71 as so redesignated-- 7,i7 in subparagraph 7,a71 by striking 7other than subsection 7b77#b772 and 7,,ii7 in subparagraph 7,b7-- 7aa7 in clause 7i7-- 7,,aa7 by striking ,except as provided in paragraph 7#c71 the and inserting ,the2 and 7,,bb7 by striking paragraphs 7#b71 7#c71 and 7#d7 and inserting paragraphs 7#a71 7#b71 and 7#c72 and 7bb7 in clause 7iv71 by striking subsection 7b77#e7 and inserting subsection 7b77#d72 and 7,e7 in subsection 7f77#b77;,a71 by striking subsection 7e77#d77;,c7 and inserting subsection 7e77#c77;,c74 7#b7 ,qualified individuals ,section #acab7;f7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjcb7;f77 is amended-- 7,a7 in the heading1 by striking 2 ,access ,limited to ,citizens and ,lawful ,residents2 and 7,b7 by striking paragraph 7#c74 7c7 ,effective date ,the amendments made by this section shall apply to years1 plan years1 and taxable years1 as applicable1 beginning after ,december #ca1 #bjbj4