• President Obama Signs ICHIA into Law! (Mon., 2/9/09)

• ICHIA Passes Senate as Part of CHIP; Now On to Conference and the President (Fri., 1/30/09)

• ICHIA Approved by Senate Finance Committee; On to Senate Floor (Fri., 1/16/09)

• Success in House; Tough Battle Ahead in Senate (Wed., 1/14/09)

• ACTION ALERT: New Congress Plans Action This Week on Immigrant Children's Health (Mon., 1/12/09)

• Immigrant Children's Health Improvement Act (ICHIA) Index

President Obama Signs ICHIA into Law!

Monday, February 9, 2009

We finally did it!! 

Thank you and congratulations to all of you who provided unwavering support to end the federally-mandated five-year waiting period for lawfully residing immigrant children and pregnant women, who were otherwise eligible for public health coverage. With the stroke of his pen on Wednesday, February 4, 2009, President Obama signed landmark legislation to provide affordable health coverage to 4.1 million newly eligible citizen and immigrant children in the U.S. and in a manner that is more equitable and will address health disparities by eliminating barriers to health care for low-income immigrants.

The Signing Ceremony

On Wednesday, February 4, President Barack H. Obama, a long-time supporter of ICHIA and CHIP, signed H.R. 2, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), in a ceremony in the East Room of the White House attended by the Act's Congressional champions as well as CHIP and ICHIA supporters, including the National Immigration Law Center. The President's powerful remarks at the signing ceremony demonstrated his leadership and commitment to a new agenda on children's health and health care for all, including immigrants.

Remarks by President Obama on Signing of Children's Health Insurance Program (CHIP) Bill 
(HTML | PDF | MSNBC Video)

The U.S. House of Representatives provided final approval to H.R. 2, only a few hours before the President signed the bill. The House's vote on February 4 (290-135) ratified changes to H.R. 2 enacted by the U.S. Senate on January 29, 2009. To see how your Senator or Representative voted, see voting records below.

H.R. 2 Votes

• House Final Passage - February 4: [http://clerk.house.gov/evs/2009/roll050.xml]
• Senate - January 29: [http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00031]
• House 1st Passage - January 14: [http://clerk.house.gov/evs/2009/roll016.xml]

H.R. 2 and Immigrants

The ICHIA provision in H.R. 2 - Section 214

Sec. 214. Permitting States To Ensure Coverage Without a 5-Year Delay Of Certain Children and Pregnant Women Under The Medicaid Program and CHIP.

Section 214 of H.R.2, allows states to cover lawfully residing children and pregnant women in Medicaid and the Children's Health Insurance Program (CHIP)(formerly called SCHIP, State Children's Health Insurance Program) with federal funds without requiring a five year waiting period. Section 214 also removes sponsor-related barriers (deeming and liability) in Medicaid and CHIP for these immigrants, in states that adopt this option.

The National Immigration Law Center will provide additional analysis regarding ICHIA and how states can take advantage of this new state option. For updates, please also regularly check NILC's ICHIA page at http://www.nilc.org/immspbs/cdev/ICHIA/index.htm.

Section 605

Section 605[1]of H.R. 2 simply confirms that undocumented immigrants remain ineligible for non-emergency Medicaid and CHIP. This does not alter or restrict existing eligibility for Emergency Medicaid or prenatal care provided under the CHIP's "fetus option," both of which remain available to otherwise eligible individuals, regardless of their immigration status.

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Thank you again for all of your incredible and tireless work on ICHIA over the last year as well as the last decade! Let's all celebrate this hard-fought victory and recognize it is an important first step towards achieving affordable health care for all, regardless of immigration status.

For more information, please contact Dinah Wiley, Public Benefits Policy Attorney, or Sonal Ambegaokar, Health Policy Attorney.
 

ICHIA Passes Senate as Part of CHIP;
Now On to Conference and the President

Friday, January 30, 2009

Last night the U.S. Senate approved the Immigrant Children's Health Improvement Act (ICHIA) as part of the 2009 Children's Health Insurance Program Reauthorization Act (CHIPRA - H.R.2).  The vote was by a comfortable, bipartisan margin of 66 - 32, with nine Republicans joining the Democrats.  Senator Kennedy, who was hospitalized after suffering a seizure on Jan. 20, was not able to vote.  (Please scroll down for the roll call results.)  CHIPRA goes to House-Senate conferees next week so that differences between each house's respective version of the bill can be reconciled, and then the final bill will go to President Obama, who has expressed strong support for this legislation.

Thank you, thank you all, for your work on this issue!  Advocates across the country took to their phones and computers to educate senators about the vital importance to children's health of passing ICHIA.  For the first time since 1996, ICHIA provides states with an option to use federal funding to cover lawfully-residing immigrant children and pregnant women during their first five years in the U.S., through Medicaid and the State Children's Health Insurance Program (now called CHIP).  The bill also eliminates barriers to health care for immigrant children and pregnant women with sponsors.

There are a few differences between the bill passed last night by the Senate and the version passed by the House earlier this month, although both versions contain ICHIA.  One difference between the bills is a Senate amendment that relates to redetermination of immigration status of ICHIA beneficiaries in states that take up this option.  The amendment, sponsored by Senator Charles Grassley (R-IA) and passed by voice vote in the Senate Finance Committee markup, requires that during a state's regular eligibility redetermination process, states ensure that noncitizen beneficiaries continue to have an immigration status that makes them eligible for the program.  This and other differences between the House and Senate versions are expected to be resolved fairly easily and quickly early next week.  House leadership may accept the Senate-passed version, and then take that back to the House floor for passage.  Once the House and Senate agree, the president is expected to sign the bill into law.

Please thank the Senators who supported ICHIA, and also the Democratic leaders -- especially Senators Reid, Durbin, Baucus, and Rockefeller -- who led the majority in passing this landmark legislation.  Thanks again for helping to improve access to health care for children and pregnant women.  We look forward to working with you to ensure that states pick up this option and to continue improving access to care.

For more information, contact Dinah Wiley, public benefits policy attorney.  More information is also available in the other articles on this webpage (see below).
 

ICHIA Approved by Senate Finance Committee; On to Senate Floor

Friday, January 16, 2009

Thanks so very much to all of you who, in a huge outpouring this past week, contacted members of the Senate Finance Committee in support of the Legal Immigrant Children's Health Improvement Act (ICHIA).  ICHIA allows states to provide health coverage under Medicaid and SCHIP to lawfully-residing children and pregnant women without a five-year waiting period.  Yesterday the committee approved ICHIA by a vote of 12 to 7 and defeated all but one amendment to undermine the provision (see press release here). 

Additional talking points on ICHIA are available here , and more background is available below.

We now need to contact every member of the U.S. Senate to urge support for coverage of immigrant children and pregnant women.  The entire body will consider ICHIA when it takes up the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) later next week or the week of January 26.

(CHIPRA reauthorizes the State Children's Health Insurance Program (SCHIP), which is due to end in March of this year.  The U.S. House of Representatives passed CHIPRA last week as HR 2, with ICHIA included as section 214 of that bill.)

Senate Finance Committee Action Yesterday

Please thank the following committee members who approved ICHIA:  the four sponsors -- Senators Rockefeller, Snowe, Bingaman, and Kerry -- plus Baucus, Conrad, Stabenow, Cantwell, Salazar, Schumer, Wyden, and Lincoln.  Those voting against ICHIA were Senators Grassley, Hatch, Crapo, Ensign, Bunning, Roberts, and Kyl.  The committee then approved by voice vote a Grassley-sponsored amendment to require states to reverify an ICHIA beneficiary's immigration status every time the state redetermines his or her SCHIP or Medicaid eligibility.  This amendment is costly, burdensome on agencies and individuals, and unnecessary because, as a general matter, ICHIA-eligible children have a stable immigration status.

Several contradictory or undermining amendments were introduced but then withdrawn after debate or defeated by similar margins.  These included amendments introduced by Senators Ensign, Kyl, and Hatch to, for example, strike ICHIA, add documentation requirements (for both U.S. citizens and immigrants), and require states to cover 95 percent of citizen children before they could cover immigrant children.

Full Senate Consideration Next Week

The full Senate will now take up CHIPRA, with ICHIA included.  We can expect Senate opponents to move to strike ICHIA from the bill and to undermine it with amendments such as those introduced in committee.


ACTION NEEDED

Please contact your Senators today and urge them to (1) strongly support access to health care for lawfully-residing immigrant children with no five-year waiting period, and (2) vigorously oppose any amendments to undermine health coverage for immigrant children and pregnant women.

Remember:  "Five years is a lifetime to a child."

Thanks for all your help!!  ICHIA has the best chance yet… right now.  It is critical that senators hear from all of you.


BACKGROUND INFORMATION

Senators whose position on ICHIA is unknown.  Casey, Dorgan, Harkin, Johnson, Klobuchar, Landrieu, Nelson (NE), Pryor, and Tester, plus all new Senators:  Begich (D-AK), Mark Udall (D-CO), Shaheen (D-NH), Tom Udall (D-NM), Hagan (D-NC), Merkley (D-OR), Warner (D-VA), Burris (D-IL), and Kaufman (D-DE).  Soon these newcomers may be joined by Bennet (D-CO) and possibly Franken (D-MN).

Senators whose support for ICHIA needs bolstering because, though they may vote for ICHIA, they may not encourage colleagues to do so and they may not oppose amendments that undermine ICHIA:  Boxer, Carper, Conrad, Feingold, Feinstein, Lautenberg, Leahy, Mikulski, Nelson (FL), Stabenow, Webb, Wyden.

Historical information.  The following Senators are among 65 who supported ICHIA in 2003 (by voting against Amendment #1011 to S.1, a Medicare bill:  Akaka, Alexander, Boxer, Brownback, Carper, Cochran, Collins, Dorgan, Feinstein, Grassley, Harkin, Inouye, Leahy, Lugar, McCain, Mikulski, Murray, Nelson (FL) and Nelson (NE), Pryor, Reed, Reid, Roberts, Specter, Stabenow, Wyden.

For more information, contact Dinah Wiley, public benefits policy attorney.
 

Success in House;
Tough Battle Ahead in Senate

Wednesday, January 14, 2009

Thank you, thank you!!

This afternoon the U.S. House of Representatives passed the former Legal Immigrant Children's Health Improvement Act (ICHIA) as section 214 of H.R. 2, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), by a strong vote of 289-139.  (See press releases from the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus.)  Your calls to your representatives have been critical to this success!

ICHIA gives states the option to enroll legal immigrant children and pregnant women in federally-funded Medicaid and CHIP with no five-year waiting period.

Senate Committee

Your activity has also moved ICHIA one step closer to passage in the Senate. Finance Committee Chairman Max Baucus (D-MT) will now allow ICHIA as an amendment and passage of that amendment in Committee is anticipated. The Committee decides tomorrow, so continued pressure on Committee members is vitally important (see NILC's alert of January 12).

Full Senate

ICHIA faces its toughest battle when CHIPRA goes to the Senate floor, and will need everyone's help to succeed. Amendments are expected from Senate opponents to strike ICHIA or to undermine one or more of its provisions. Start contacting your Senators now and telling them (1) to support ending the five year waiting period for immigrant children, and also (2) to oppose any amendments that would compromise coverage of immigrant children.

For more information, contact Dinah Wiley, public benefits policy attorney.
 

A FIRST STEP TOWARDS ACHIEVING EQUITY IN HEALTH CARE

New Congress Plans Action This Week on Immigrant Children's Health

Monday, January 12, 2009

IMMEDIATE ACTION NEEDED
Call Senators to Urge Support for ICHIA

ICHIA up for debate again this week

This week, Congress is planning to vote on bills to expand children's health care through a new reauthorization of the State Children's Health Insurance Program (SCHIP).  While it is necessary for Congress to reauthorize SCHIP before current funding expires in March 2009, it is imperative that Congress passes a 2009 SCHIP bill that demonstrates our nation's priorities to children's access to health care and our commitment to a fair and equitable health care system that ensures all children have an opportunity to become healthy citizens.

Under current law, legal immigrant children and pregnant women must wait five years before they become eligible for federally funded Medicaid and SCHIP. Americans believe this waiting period is wrong and want it eliminated.[1]  Congress can address this inequity by including the Legal Immigrant Children's Health Improvement Act (ICHIA) in the 2009 SCHIP reauthorization bill.[2]  Moreover, in these difficult economic times, Congress should be finding ways to help America's working families and states with tight budgets. ICHIA would provide fiscal relief to families as well as states and would be a key component of a strong health reform foundation. Congress needs to pass ICHIA now, and demonstrate its commitment to children and a health care system that works for all Americans.

Timing

The U.S. House of Representatives will be voting on a new SCHIP bill as early as Wednesday, January 14. There is strong support for including ICHIA in the House version of a SCHIP bill. The Senate is working on its SCHIP bill with a vote likely later this week. As in the past, a minority of Senators threaten to use anti-immigrant tactics to block inclusion of ICHIA in what should only be a debate about how best to provide health care to America's children.

Your voice is needed today to ensure that key members of the Senate hear that we want all children to have the opportunity to be healthy and to remove archaic barriers such as the five year bar.

Action Needed

As of today, the Senate Finance Committee plans to send SCHIP to the full Senate on Thursday without ICHIA. Please immediately contact the following Finance Committee members. Tell these Senate Finance Committee Members that the Senate's SCHIP bill MUST INCLUDE ICHIA.

Additional talking points on ICHIA are available here.

Senate Finance Committee Members

Member has been supportive in the past but has not confirmed support this year:
Max Baucus (D-MT), Chair
Kent Conrad (D-ND)
Ron Wyden (D-OR)
Debbie Stabenow (D-MI)

Member's current position on ICHIA is unknown:
Charles Grassley (R-IA), Ranking Member
Ken Salazar (D-CO)
Orrin Hatch (R-UT)
Pat Roberts (R-KS)
Jon Kyl (R-AZ)
Jim Bunning (R-KY)
Mike Crapo (R-ID)
John Ensign (R-NV)

The following members are supportive and have indicated they will vote "Yes" ON ICHIA:
John Rockefeller (D-WV), Jeff Bingaman (D-NM), John Kerry (D-MA), Blanche Lincoln (D-AR), Charles Schumer (D-NY), Maria Cantwell (D-WA), and Olympia Snowe (R-ME).  If you have time, please thank them for their support.

For contact information for Senate Finance Members, please go to the website link below, scroll down, click on the member, call their office, and ask to speak to the HEALTH staff:
www.congress.org/congressorg/directory/committees.tt?commid=sfina

Other Members

If you have additional time, please call your own two Senators and your Representative and let them know that their support for inclusion of ICHIA in SCHIP this week will be critical to the future of all children, not just immigrant children.

Thanks for all your help - it is critical Congress hears from all of you! We are close to the finish line and we need everyone's help to make this happen this year!

For More Information

Contact Dinah Wiley, Public Benefits Policy Attorney, or Sonal Ambegaokar, Health Policy Attorney.
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[1] In a November 2008 poll, more than three out of four Americans favor ending the five-year waiting period for Medicaid and SCHIP which immigrant children and pregnant women are subjected to by law.  More information about the poll is available here.

[2] Under current federal law, lawfully residing pregnant women and children who have entered the country since August 22, 1996 are barred from Medicaid and SCHIP for five years. This restriction is not only on its face discriminatory, but has clearly increased racial and ethnic health disparities among children in the U.S. The Immigrant Children's Health Improvement Act (ICHIA, S.764, H.R.1308) would eliminate the waiting period and address health disparities. ICHIA has long-standing bipartisan support and strong support from hundreds of national and state organizations. More information about ICHIA is available here.