Health Equity and Access under the Law for Immigrant Women and Families Act of 2017

Summary: Health Equity and Access under the Law for Immigrant Women and Families Act of 2017 or the HEAL Immigrant Women and Families Act of 2017 This bill amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act to extend Medicaid and CHIP coverage to aliens lawfully present in the United States who otherwise meet eligibility requirements. This applies to individuals granted deferred action or other federally authorized presence but not to nonimmigrants (e.g., individuals with a temporary worker visa). Individuals granted federally authorized presence, except nonimmigrants, are eligible for health insurance exchanges and reduced cost sharing under the Patient Protection and Affordable Care Act and premium subsidies under the Internal Revenue Code.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Equity and Access under the 
Law for Immigrant Women and Families Act of 2017'' or as the ``HEAL for 
Immigrant Women and Families Act of 2017''.

SEC. 2. FINDINGS; PURPOSE.

    (a) Findings.--Congress finds as follows:
            (1) Insurance coverage reduces harmful health disparities 
        by alleviating cost barriers to and increasing utilization of 
        basic preventive health services, especially among low-income 
        and underserved populations, and especially among women.
            (2) Based solely on their immigration status, many 
        immigrants and their families face legal restrictions on their 
        ability to obtain health insurance coverage through Medicaid, 
        CHIP, and Health Insurance Exchanges.
            (3) Lack of health insurance contributes to persistent 
        disparities in the prevention, diagnosis, and treatment of 
        negative health outcomes borne by immigrants and their 
        families.
            (4) Immigrant women are disproportionately of reproductive 
        age, low-income, and lacking health insurance coverage. Legal 
        barriers to affordable health insurance coverage therefore 
        particularly exacerbate their risk of negative sexual, 
        reproductive, and maternal health outcomes, with lasting health 
        and economic consequences for immigrant women, their families, 
        and society as a whole.
            (5) Denying coverage or imposing waiting periods for 
        coverage unfairly hinders the ability of immigrants to take 
        responsibility for their own health and economic well-being and 
        that of their families. To fully and productively participate 
        in society, access to health care is fundamental, which for 
        women includes access to the services necessary to plan whether 
        and when to have a child.
            (6) The population of immigrant families in the United 
        States is expected to continue to grow. Indeed one in four 
        children in the United States is part of an immigrant family. 
        It is therefore in the Nation's shared public health and 
        economic interest to remove legal barriers to affordable health 
        insurance coverage based on immigration status.
            (7) Although Deferred Action for Childhood Arrivals (DACA) 
        recipients are authorized to live and work in the United 
        States, they have been unfairly excluded from the definition of 
        lawfully present and lawfully residing for purposes of health 
        insurance coverage by the Department of Health and Human 
        Services, including Medicaid and the Children's Health 
        Insurance Program (CHIP).
            (8) Immigration law is constantly evolving and new 
        immigration categories for individuals with federally 
        authorized presence in the United States may be created.
    (b) Purpose.--It is the purpose of this Act to ensure that all 
individuals who are granted federally authorized presence are treated 
as being lawfully present in the United States for purposes of 
eligibility under all federally funded health care programs.

SEC. 3. REMOVING BARRIERS TO HEALTH COVERAGE FOR LAWFULLY PRESENT 
              INDIVIDUALS.

    (a) Medicaid.--Section 1903(v)(4) of the Social Security Act (42 
U.S.C. 1396b(v)(4)) is amended--
            (1) by amending subparagraph (A) to read as follows:
    ``(A) Notwithstanding sections 401(a), 402(b), 403, and 421 of the 
Personal Responsibility and Work Opportunity Reconciliation Act of 
1996, payment shall be made under this section for care and services 
that are furnished to aliens, including those described in paragraph 
(1), if they otherwise meet the eligibility requirements for medical 
assistance under the State plan approved under this title (other than 
the requirement of the receipt of aid or assistance under title IV, 
supplemental security income benefits under title XVI, or a State 
supplementary payment), and are lawfully present in the United States 
(including such an individual who is granted deferred action or other 
federally authorized presence other than as a nonimmigrant).'';
            (2) in subparagraph (B)--
                    (A) by striking ``a State that has elected to 
                provide medical assistance to a category of aliens 
                under subparagraph (A)'' and inserting ``aliens 
                provided medical assistance pursuant to subparagraph 
                (A)''; and
                    (B) by striking ``to such category'' and inserting 
                ``to such alien''; and
            (3) in subparagraph (C)--
                    (A) by striking ``an election by the State under 
                subparagraph (A)'' and inserting ``the application of 
                subparagraph (A)'';
                    (B) by inserting ``or be lawfully present'' after 
                ``lawfully reside''; and
                    (C) by inserting ``or present'' after ``lawfully 
                residing'' each place it appears.
    (b) CHIP.--Subparagraph (M) of section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:
                    ``(M) Paragraph (4) of section 1903(v) (relating to 
                lawfully present individuals).''.
    (c) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section shall take effect on the date 
        of the enactment of this Act and shall apply to services 
        furnished on or after the date that is 90 days after such date 
        of the enactment.
            (2) Exception if state legislation required.--In the case 
        of a State plan for medical assistance under title XIX, or a 
        State child health plan under title XXI, of the Social Security 
        Act which the Secretary of Health and Human Services determines 
        requires State legislation (other than legislation 
        appropriating funds) in order for the plan to meet the 
        additional requirements imposed by the amendments made by this 
        section, 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 the enactment of this 
        Act. For purposes of the previous sentence, in the case of a 
        State that has a 2-year legislative session, each year of such 
        session shall be deemed to be a separate regular session of the 
        State legislature.

SEC. 4. CONSISTENCY IN HEALTH COVERAGE FOR INDIVIDUALS WITH FEDERALLY 
              AUTHORIZED PRESENCE, INCLUDING DEFERRED ACTION.

    (a) In General.--For the purposes of eligibility under any of the 
provisions referred to in subsection (b), all individuals granted 
federally authorized presence in the United States other than as a 
nonimmigrant shall be considered to be lawfully present in the United 
States.
    (b) Provisions Described.--The provisions described in this 
subsection are the following:
            (1) Exchange eligibility.--Section 1311 of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18031).
            (2) Reduced cost-sharing eligibility.--Section 1402 of the 
        Patient Protection and Affordable Care Act (42 U.S.C. 18071).
            (3) Premium subsidy eligibility.--Section 36B of the 
        Internal Revenue Code of 1986.
            (4) Medicaid and chip eligibility.--Titles XIX and XXI of 
        the Social Security Act, including under section 1903(v) of 
        such Act (42 U.S.C. 1396b(v)).
    (c) Effective Date.--
            (1) In general.--Subsection (a) shall take effect on the 
        date of the enactment of this Act.
            (2) Transition through special enrollment period.--In the 
        case of an individual described in subsection (a) who, before 
        the first day of the first annual open enrollment period under 
        subparagraph (B) of section 1311(c)(6) of the Patient 
        Protection and Affordable Care Act (42 U.S.C. 18031(c)(6)) 
        beginning after the date of the enactment of this Act, is 
        granted federally authorized presence in the United States 
        described in subsection (a) and who, as a result of such 
        subsection, qualifies for a subsidy described in paragraph (2) 
        or (3) of such subsection, the Secretary of Health and Human 
        Services shall establish a special enrollment period under 
        section 1311(c)(6)(C) of such Act during which such individual 
        may enroll in qualified health plans through Exchanges under 
        title I of such Act and qualify for such a subsidy. For such an 
        individual who has been granted federally authorized presence 
        in the United States as of the date of the enactment of this 
        Act, such special enrollment period shall begin not later than 
        90 days after such date of enactment. Nothing in this paragraph 
        shall be construed as affecting the authority of the Secretary 
        to establish additional special enrollment periods under 
        section 1311(c)(6)(C) of the Patient Protection and Affordable 
        Care Act (42 U.S.C. 18031(c)(6)(C)).