Support the HEAL Immigrant Women and Families Act!

This article was originally published by the National Center for Lesbian Rights.

Lauren Paulk is the Law Students for Reproductive Justice Fellow at the National Center for Lesbian Rights.

Though the Affordable Care Act (ACA) will go a long way toward ensuring access to quality healthcare for most LGBT individuals, many LGBT immigrants are still prohibited from obtaining the affordable health care they need. Despite being authorized to live and work in the United States, many immigrants—including LGBT immigrants—are ineligible for affordable health coverage and care through vital programs like Medicaid and the Children’s Health Insurance Program (CHIP).

Many immigrants are subject to a ban that makes them ineligible for federal Medicaid and CHIP for at least the first five years they are authorized to live and work in the United States, and other lawfully present immigrants who do not fall into an outdated and restrictive list of “qualified” immigrants are barred altogether. Since immigrants—particularly LGBT immigrants—are disproportionately low-income, it can be difficult or impossible to obtain the health care they need. That means five years without insurance coverage for critical and life-saving services, including pap smears, mammograms, HIV treatment, mental health care, or pediatric care for children.

Young people granted status through “Deferred Action for Childhood Arrivals” (DACA) are forced to wait even longer. DACA refers to a program enacted in 2012 that allows undocumented people ages 15-30 who arrived in the US as children (and who are currently in school or working) to remain here for renewable two-year periods. While they are considered lawfully present and are eligible to work and pay into public health benefits systems, they are prevented from accessing affordable care. Currently, people with DACA status are ineligible for federal Medicaid or CHIP coverage and the years they live in the United States with DACA status will not count toward the five years of lawful presence required before they become eligible. To add insult to injury, these young people are even ineligible to purchase private health insurance on the ACA exchange—with or without federal subsidies.

Many LGBT immigrants come to the US after fleeing interpersonal and state abuse based on their sexual orientation or gender identity. However, once they arrive, LGBT immigrants face a number of challenges to obtaining affordable and culturally competent health care. While the ACA will continue to combat the discrimination LGBT people face in the health care system due to lack of cultural competency, all of its positive effects are out of reach for LGBT immigrants because of gaps in coverage. The existing barriers to affordable health care disenfranchise hard-working LGBT immigrants who come to the United States to have a better life, only to encounter difficulty getting the care they need. Moreover, because LGBT immigrants are much less likely than non-immigrants to be able to access health care through their jobs, they are putting work into a system that does not support them.

However, new legislation introduced by Congresswoman Michelle Lujan Grisham would change these realities for good. The Health Equity and Access under the Law for Immigrant Women and Families Act of 2014 (“HEAL Immigrant Women and Families Act” for short) restores access to Medicaid and CHIP for immigrants authorized to live and work in the United States who are otherwise eligible. The bill also extends full participation in the ACA to young people granted status under DACA.

The HEAL Immigrant Women and Families Act is especially important for families. LGBT families are more likely to live in poverty than non-LGBT families, meaning health care on the private market is often out of reach. We know that LGBT people deserve the same access to health care as non-LGBT people, and this should include LGBT immigrants. The HEAL Immigrant Women and Families Act would bridge the gaps in the ACA, Medicaid, and CHIP by extending needed care options to immigrants, and in so doing, strengthen our workplace, our economy, and our communities. NCLR applauds Congresswoman Lujan Grisham for introducing the HEAL Immigrant Women and Families Act, and we encourage other members of Congress who support the LGBT community to stand beside her in expanding the health care options for many LGBT immigrants. Please show your support for the HEAL Immigrant Women and Families Act by signing this pledge, put together by the National Latina Institute for Reproductive Health. Please check out @NLIRH’s twitter timeline for more information on how this important bill will impact our communities!

I’m a fan of birth control and religious freedom

Melissa Torres-Montoya, Resident Blogger (’11, University of California, Berkeley School of Law)

Admittedly, I’m a huge fan of March Madness. I jumped on board with the madness; making the effort to watch my favorite team (go Bruins!) specifically at the bar that serves as DC’s “official” UCLA bar, hanging out with friends who had brackets so we could enthusiastically and nonstop talk/compare our brackets, and basically addictively watching the games.  While this March Madness is at the end of the day all fun and games, the real madness that is going on this March is the Supreme Court hearing of Sebelius v. Hobby Lobby.
The precise legal question has to do with religious freedom.  As this National Public Radio piece points out, the legal standard for whether a law infringes upon the constitutionally granted right from laws “prohibiting the free exercise” of religion has changed over the years.  And this summer the Supreme Court will issue its decision as to whether  the new law requiring employers to provide health insurance that includes coverage for contraception poses a substantial burden on the corporate owner’s of Hobby Lobby’s right to free exercise of religion and whether as corporate owners they even have such a legal right.  The madness in this all, for me, is the non legal question here is that, for some, the question exists as to whether contraception is even considered a preventive health measure.  
Former Bush administration Solicitor General Paul Clement bemoans that “The federal government for the first time has decided that they are going to force one person to pay for another person’s not just … hip replacement, but something as religiously sensitive as contraception and abortifacients.”  Hobby Lobby, of course, would never challenge coverage of a hip replacement for a 75 year old employee who fell down the stairs.  Nor should they challenge the use of a medication by a 34 year old fertile woman to prevent pregnancy, a medical condition that changes a woman’s body so that she’ll grow a whole new human within her.  According to the world health organization family planning, “allows spacing of pregnancies and can delay pregnancies in young women at increased risk of health problems and death from early childbearing, and can prevent pregnancies among older women who also face increased risks.”  Spacing of pregnancies, as experts at the Mayo Clinic describe, has medical implications.  So yes, contraception is just another medical treatment that should be included in health insurance coverage as routinely as say, a hip replacement or high cholesterol medication. Hopefully, a majority of the justices see it the same way and publicly identify contraception as a critical, routine and medically accepted preventive health measure.
Today, the Supreme Court is listening to oral arguments on this case and like most women in the U.S., I oppose Hobby Lobby’s attempt to carve out some contraception from the health insurance plan it provides its employees. I’m publicly acknowledging today that I’m a fan of birth control and religious freedom.  You should too.  Make your new cover page this or pledge your support here.

Anniversary Reminds Us Not To Turn Back

S J Chapman, Resident Blogger, (’12, Northwestern University Law School)

To mark the 41st anniversary of Roe v. Wade, the Center for Reproductive Rights is producing a series of PSAs urging Americans to stand up for reproductive rights.

The latest features Tony and Grammy Award winner Dee Dee Bridgewater, sharing the harrowing account of her 1968 pre-Roe abortion.  I was struck by the candor and poignancy of Dee Dee’s story, which epitomized the lack of dignity that accompanies government restrictions on abortion: “I remember being very humiliated… to the point that today I haven’t thought about this for years; thinking about it makes me want to cry.”

The PSA encourages people to take a stand against governmental intrusion into reproductive decisions.  As Dee Dee asserts, “I don’t think its right that our politicians can choose for women what their reproductive choices are … you are the one who should decide what you will do with your body.”

I urge everyone to take a few minutes to watch Dee Dee’s video.

Once you’ve seen Dee Dee’s story, you might also want to see the first PSA in the series by reproductive rights advocate Mark Ruffalo, who shares the story of his mother’s pre-Roe abortion experience.  It shocked him to learn that to get an abortion, women had to “search out doctors at night, miles and miles and miles away from their home, in a closed-down doctors office or motel room.”  He concluded by saying “I can’t stand aside with two beautiful young girls of my own and accept that we are going to return to those days.”

Let’s follow Dee Dee and Mark’s examples by working together to ensure our reproductive choices are ours, not the government’s.

Republicans State of Abortion Address

Christine Poquiz, Resident Blogger (’12, University of California, Davis School of Law)

After celebrating the 50th anniversary of the “War on Poverty” and on the day of President Obama’s State of the Union address focusing on the economy and poverty, what do House Republicans spend their valuable time on? You got it–abortion. Like voting to repeal Obama care for the 40umpteenth time, Republicans dogged focus on anti-abortion measures, that won’t reach the Senate, are infuriating to say the least. Republicans are once again obsessed with denying women the ability to make their own personal reproductive health decisions. If the all-male HR7 hearing is any indication, instead of waging a war on poverty, Republicans are waging a war against poor women who aren’t able to pay for abortion care.

HR7 deemed the “No Taxpayer for Abortion Act” is an extreme abortion ban that withholds coverage from virtually all women in the U.S. There are current laws that ban women who use Medicaid as their insurance, to cover their abortion care. This law would extend this coverage ban to both public and private insurance companies. There was even an original “rape audit” provision that would require women to prove to the IRS their rape or incest circumstance in order to get insurance coverage for their abortion. Conservatives took this portion out of the bill to make it seem more palatable, believing that the other provisions of the bill are that much more reasonable.

There was one highlight of the hearing, and one of the few moments I was not yelling at my computer screen, when Democrats stepped up and used this opportunity to talk about real issues our country is facing, like unemployment and the job market, instead of this anti-women absurdity. The optics of democrats lining up and repeatedly insert their statement into the record “in support of extending unemployment insurance for 1.6 million Americans instead of this radical Republican assault on women’s health care rights,” was right out of the conservative play book.

After the Republican controlled House passed the measure 227-188, the GOP undoubtedly wanted to show that they do support women and chose Rep. Cathy McMorris to give the party’s rebuttal to Obama’s State of the Union address. McMorris brought up abortion (shock!), an issue that didn’t come up in Obama’s address. McMorris talked about her own personal circumstances, how she and her husband have a son with Down syndrome who has been able to thrive, and therefore abortion should not be a viable option for other women. It is wonderful that McMorris’ son is doing so well and I’m sure their family has their share of struggles. I hope nothing but the best for her family, but not every woman will have the same experiences and resources, it is simply not a reason to make pregnancy decisions for others and their families.

However we feel about abortion, politicians shouldn’t be allowed to deny a woman’s insurance coverage for it just because she’s struggling to get by. When it comes to the most important decisions in life, such as whether to become a parent, it is vital that a woman is able to consider all her options–including an abortion–even if she is poor. Instead of sweeping bans, it’s time for Congress to lift the restrictions on abortion coverage so women can make decisions based on what’s best for their circumstances.

Roe: One Con Law Experience

Amanda Shapiro, Resident Blogger (’15, Brooklyn Law School)

I had been dreading and yet also looking forward to this con law class for months – the class on Roe v. Wade. The attacks on Roe were the reason I came to law school. I meticulously read the opinion the night before, and steadied myself for a battle. But the class came and went without so much as a 1L wincing at the word “abortion,” which turned out being the worst case scenario – Roe passing by as just another case to remember for the final.

I looked back at the (truncated) case in my textbook and realized that all of the fervor from the opinion had been sucked dry. There was nothing from the original opinion on the incredible hurdles that women had transcended to get an abortion, or on the devastating effects unplanned pregnancies had on women who were forced to carry them to term. Or just as importantly, there was no discussion of the federal and state policies put in place since Roe that have made it so difficult to access abortion that Roe is practically moot.  Instead, my 1L con law class read a few legalese passages on the “penumbra” of privacy rights. So for Roe’s anniversary, as a LSRJ chapter leader at my law school, I hope to bring the real Roe story to my classmates – that it’s not just a case to memorize for the final, its about women and our right to control our bodies

Roe v. Wade: A Reminder That We Deserve More

Candace Gibson, Resident Blogger (’12, University of Utah S.J. Quinney College of Law)

I first learned about Roe v. Wade as an eager, nerdy, middle school student. No, it was definitely not covered in my history classes and it was barely discussed in my constitutional law class. I learned about it because my Latina mother introduced me to the world of feminism and feminist heroes at a young age. When I first learned about Roe, I was amazed and thought it was the best thing that ever happened to the women’s movement.  As each anniversary passes, I’m less amazed and more circumspect about the meaning of Roe. I know now that we have a long way to go before we achieve full equality and justice for all women, including transgender men. Roe is not the pinnacle of our movement, but it is a starting point.

Since Roe, it’s relevance to women’s lives has become somewhat diminished due to relentless political assaults.  In 1976, Congress passed the Hyde Amendment, which is an almost total ban on abortion coverage for women who qualify and are enrolled in Medicaid, making abortion inaccessible in practice for low income women of color.  It has continuously been reauthorized in each federal budget.  Lack of insurance coverage for abortion care isn’t the only barrier for many women.  Several states have passed laws to “regulate” abortion care, again effectively making it inaccessible – take for instance TRAP regulations and laws pertaining to misoprostol.  Then, we have issues of accessing care – many women live in areas of the country where there are no abortion providers and they do not have the means to travel to the closest abortion provider,sometimes hours away. And’s let not forget about Casey and the “undue burden” standard.

Finally, transgender men who may need abortion care may not receive the care they need because of the lack of culturally competent providers in general for this community, let alone providers who are trained and licensed in providing abortion care.  Not to mention the fact that transgender and gender non-conforming persons also face high rates of discrimination and violence, even in healthcare settings.   

So yes, let’s celebrate Roe v. Wade, but the next day we need to get back to work.   

I’m in the 78%. Taking Back the Narrative: Asian American and Pacific Islanders DO Support Abortion.

Christine Poquiz, Resident Blogger (’12, University of California, Davis School of Law)

Working as a reproductive justice fellow at the National Asian Pacific American Women’s Forum (NAPAWF), we’re often combating myths (model minority anyone?) and misconceptions around the Asian American and Pacific Islander community.  AAPI women, activists, and organizers are speaking up, fighting back, and recreating the narrative around our community. A few months ago the hashtag #notyourasiansidekick took off on twitter to talk about the struggles that Asian American women face and AAPI feminism. The response to this hashtag was overwhelming and showed how many young AAPI women wanted a forum to talk about these issues. [click here to see the follow-up Google Hangout with NAPAWF’s executive director, Miriam Yeung]

On this 41st anniversary of the landmark decision Roe v. Wade, there are misconceptions that AAPI women aren’t affected by attacks on abortion rights. However, bans against public insurance coverage of abortion, like the Hyde Amendment, cause great harm for subpopulations of the AAPI community who depend on public insurance like Medicaid. Furthermore there is evidence that AAPI women use birth control at lower rates than the general public, have high rates of unintended pregnancies and utilize abortion services at higher rates. On top of all that, some legislators are using stereotypes about Asian American women to pass sex selective abortion bans that encourage racial stereotyping of AAPI women in the doctor’s office and could possibly even cause doctors to deny care to women in our community. AAPI women are significantly affected by attacks on abortion access.

The AAPI community needs to shape the conversation about us, or other people will do it instead. One traditional perception about the AAPI community is that we’re conservative in our values. However, from the National Asian American Survey (NAAS), which conducted opinion polling on over 6,000 AAPIs, showed that the AAPI community is progressive in our values. During this celebration of Roe, it’s crucial to highlight that 78% of AAPIs support some form of legal abortion. Furthermore, 69% of AAPIs believe that the government should stay out women’s personal decision-making.

Here at NAPAWF, we’re big proponents for data disaggregation, and the 78% is not reflective of each AAPI subpopulation. For example, the traditionally Catholic Filipino community is less supportive of legal abortion than the rest of the AAPI community. But even among the Filipino community, over 50% support some form of legal abortion. Moreover, there are higher rates of “I don’t know” within the Vietnamese and Hmong community, which shows advocates like us that there needs to be more culturally competent education around this issue for these communities.

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Most importantly, these top line numbers break the notion that AAPIs don’t support abortion. This year, NAPAWF is uplifting these numbers to show that AAPIs are supportive of abortion and a woman’s personal decision making. Our members, community leaders, and elected officials are taking part in a photo campaign saying that they’re part of the 78% and that they support Roe.

We’re working on changing the narrative. Send in your photo saying you’re part of the 78% today.

Comprehensive sex ed is essential, not “too racy” for youth

Melissa Torres-Montoya, Resident Blogger (’11, University of California, Berkeley School of Law)

2014 brought many fresh starts for me, most predominately the start of a new job in HIV/AIDs policy.  I spent much of my first week at my job better familiarizing myself with HIV/AIDs policy by plowing through many research studies and reports.

I happened upon a report by the Center for American Progress and my alma mater UC Berkeley School of Law exploring barriers to prevention and treatment of HIV among communities of color; making the case for a holistic approach to eliminate racial disparities in HIV/AIDs.  The report includes a recommendation for free comprehensive sex education. While comprehensive sex ed seems like a given for combating the epidemic of HIV, the report notes that despite the effectiveness of sex education, “conservatives have often opposed programs such as condom education and distribution.”  Such opposition to comprehensive sex education has led to “abstinence-only” education, most notably in the South, where the report also noted that the prevalence of abstinence-only education likely contributes in part to why residents of the South are  “significantly less likely to obtain treatment to [HIV] once infected” than people in all other parts of the U.S.

It did not take long for the reality of this to come to light for me, as the same day I read this report one of the top stories in my google alerts was about how some parents in Charlotte, North Carolina find a sex education curriculum “too racy”to be taught at large to their ninth grade students because it includes a chapter entitled “How to Make Condoms Fun and Pleasurable.”  Teaching about how condoms can be fun and pleasurable is an effort to increase use of condoms among teens engaging in sexual activity to prevent unplanned pregnancy and transmission of HIV and other STIs.  Including a section in sex education curriculum that presents condoms in a way that tried to increase their use is a valuable and essential because it promotes safer sex practices among teens and the adults they will grow up to become.

As a former Law Students for Reproductive Justice fellow, it is obvious to me how reproductive justice intersects with health equity and justice issues, I only wish all policy makers and parents alike did too.

18.7 percent is not enough

Deodonne Bhattarai, Resident Blogger (’12, Northeastern University School of Law)

This month marks the start of the second session of the 113th Congress — the most diverse Congress in U.S. history.   My own home state of New Hampshire played a big role in this distinction having sent the only ever all female delegation to Washington, D.C.  Hawaii is a close second, having sent three women as part of its four-member delegation. However, with eighty-one House members and twenty Senators, women still account for only 18.7% of Congressional members.[1]

Despite their comparatively low numbers, women have increasingly gained recognition for their leadership on a variety of issues.  Barbara Mikulski (D-MD), Susan Collins (R-ME), Kelley Ayotte (R-NH) and others garnered attention for their role in last year’s budget negotiations and are largely credited for saving our country from the dreaded fiscal cliff.  Senator Mazie Hirono (D-HI) became the voice for family unity and women’s equality during the immigration debate introducing a number of amendments including one to allocate 30,000 residency cards for traditionally female employment, employment that goes largely unrecognized in our current system.

The Shaheen amendment, passed late in 2012, and named for Jeanne Shaheen (D-NH), ended the decades long ban on insurance coverage for abortion services for military rape survivors. The attention to sexual violence in the military has only grown over the past year thanks to the efforts of Senators Kirsten Gillibrand (D-NY) and Claire McCaskill (D-MO).  Although not always in agreement – only eighteen of the twenty female Senators are pro-choice – the women serving in Congress are a force in their own right.  A recent study found that regardless of their party, women are “thirty-one percent more effective than men at advancing legislation.”

As we embark on the second session of this historic Congress, it is tempered by the fact that half of all states have never elected a woman to the Senate and in the words of Sen. John McCain (R-AZ), “Imagine what they could do if there were 50 of them.”



[1] https://www.fas.org/sgp/crs/misc/R42964.pdf

2014 New Years Resolution: Visit the Gynecologist

S J Chapman, Resident Blogger, (’12, Northwestern University Law School)

Couldn’t think of a new years resolution?  I have one for you: visit your gynecologist!  Women no longer have to worry about copays, coinsurance, or having to meet a deductible before seeing a gynecologist for preventive health services.

While most plans under the Affordable Care Act have deductibles – some as high as $5,000[1] – that must be met before insurance will cover medical services, the Affordable Care Act carves out an exception to this rule when it comes to preventive care for women.  Even if a deductible hasn’t been met, women are able to receive a range of preventive services – without even having to pay a copayment or coinsurance!

Covered services include well-woman visits, breastfeeding comprehensive support and counseling, and all FDA approved contraceptive methods.You can find a list of these preventive services at healthcare.gov.

This coverage is radically paving the way for 19 million uninsured women for whom access to insurance was not previously feasible[2] to empower themselves through preventive care.  Last year a review of 66 studies concluded that access to contraception positively impacts women’s participation in education and the workforce, contributes to earning power, family stability, mental health and happiness, and their children’s well-being.[3]

Even if you do have resolutions, go ahead and tack this one on: resolve to take advantage of your new legal right to preventive care, and visit a gynecologist in your network in 2014.

If your provider tries to charge a co-payment, deductible, or co-insurance for the covered preventive services, check out this toolkit created by our friends at the National Women’s Law Center with instructions for sending appeal letters.



[1] http://www.nbcnews.com/health/consumers-beware-not-all-health-plans-cover-doc-visit-deductible-2D11794861

[2] http://kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage-fact-sheet/

[3] http://www.guttmacher.org/media/nr/2013/03/21/index.html