I 

114TH CONGRESS 

1ST SESSION H. R. 1974 

To expand access to health care services, including sexual, reproductive, 

and maternal health services, for immigrant women, men, and families 

by removing legal barriers to health insurance coverage, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 22, 2015 

Ms. MICHELLE LUJAN GRISHAM of New Mexico (for herself, Mr. TAKAI, Mr. 

VEASEY, Mr. TAKANO, Mr. RANGEL, Mr. GRIJALVA, Ms. LEE, Ms. PINGREE, Ms. SLAUGHTER, Ms. CLARK of Massachusetts, Ms. NORTON, Ms. 

SCHAKOWSKY, Ms. WILSON of Florida, Ms. LORETTA SANCHEZ of California, Mr. VARGAS, Mr. GUTIE ́RREZ, Mr. MCGOVERN, Mr. SERRANO, 

Mr. O’ROURKE, Mr. JOHNSON of Georgia, Ms. ROYBAL-ALLARD, Mr. 

HONDA, Mrs. TORRES, Ms. LINDA T. SA ́NCHEZ of California, Mr. TED

LIEU of California, Ms. FUDGE, Mr. CA ́RDENAS, Ms. MOORE, Ms. 

BROWN of Florida, Ms. LOFGREN, Ms. EDDIE BERNICE JOHNSON of 

Texas, Mr. GRAYSON, and Ms. MENG) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committee on Ways and Means, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To expand access to health care services, including sexual, 

reproductive, and maternal health services, for immigrant 

women, men, and families by removing legal barriers 

to health insurance coverage, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Health Equity and 

3 Access under the Law for Immigrant Women and Families 

4 Act of 2015’’ or as the ‘‘HEAL for Immigrant Women 

5 and Families Act of 2015’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Insurance coverage reduces harmful health 

9 disparities by alleviating cost barriers to and in10 creasing utilization of basic preventive health serv11 ices, especially among low-income and underserved 

12 populations, and especially among women. 

13 (2) Based solely on their immigration status, 

14 many immigrants and their families face legal re15 strictions on their ability to obtain health insurance 

16 coverage through Medicaid, CHIP, and Health In17 surance Exchanges. 

18 (3) Lack of health insurance contributes to per19 sistent disparities in the prevention, diagnosis, and 

20 treatment of negative health outcomes borne by im21 migrants and their families. 

22 (4) Immigrant women are disproportionately of 

23 reproductive age, low-income, and lacking health in24 surance coverage. Legal barriers to affordable health 

25 insurance coverage therefore particularly exacerbate 

26 their risk of negative sexual, reproductive, and maVerDate Sep 11 2014 05:46 May 05, 2015 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1974.IH H1974

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1 ternal health outcomes, with lasting health and eco2 nomic consequences for immigrant women, their 

3 families, and society as a whole. 

4 (5) Denying coverage or imposing waiting peri5 ods for coverage unfairly hinders the ability of immi6 grants to take responsibility for their own health 

7 and economic well-being and that of their families. 

8 To fully and productively participate in society, ac9 cess to health care is fundamental, which for women 

10 includes access to the services necessary to plan 

11 whether and when to have a child. 

12 (6) The population of immigrant families in the 

13 United States is expected to continue to grow. In14 deed one in four children in the United States is 

15 part of an immigrant family. It is therefore in the 

16 Nation’s shared public health and economic interest 

17 to remove legal barriers to affordable health insur18 ance coverage based on immigration status. 

19 SEC. 3. REMOVING BARRIERS TO HEALTH COVERAGE FOR 

20 LAWFULLY PRESENT INDIVIDUALS. 

21 (a) MEDICAID.—Section 1903(v)(4) of the Social Se22 curity Act (42 U.S.C. 1396b(v)(4)) is amended— 

23 (1) by amending subparagraph (A) to read as 

24 follows: 


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1 ‘‘(A) Notwithstanding sections 401(a), 402(b), 403, 

2 and 421 of the Personal Responsibility and Work Oppor3 tunity Reconciliation Act of 1996, payment shall be made 

4 under this section for care and services that are furnished 

5 to aliens, including those described in paragraph (1), if 

6 they otherwise meet the eligibility requirements for med7 ical assistance under the State plan approved under this 

8 title (other than the requirement of the receipt of aid or 

9 assistance under title IV, supplemental security income 

10 benefits under title XVI, or a State supplementary pay11 ment), and are lawfully present in the United States (in12 cluding such an individual who is granted deferred ac13 tion).’’; 

14 (2) in subparagraph (B)— 

15 (A) by striking ‘‘a State that has elected to 

16 provide medical assistance to a category of 

17 aliens under subparagraph (A)’’ and inserting 

18 ‘‘aliens provided medical assistance pursuant to 

19 subparagraph (A)’’; and 

20 (B) by striking ‘‘to such category’’ and in21 serting ‘‘to such alien’’; and 

22 (3) in subparagraph (C)— 

23 (A) by striking ‘‘an election by the State 

24 under subparagraph (A)’’ and inserting ‘‘the 

25 application of subparagraph (A)’’; 


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1 (B) by inserting ‘‘or be lawfully present’’ 

2 after ‘‘lawfully reside’’; and 

3 (C) by inserting ‘‘or present’’ after ‘‘law4 fully residing’’ each place it appears. 

5 (b) CHIP.—Subparagraph (J) of section 2107(e)(1) 

6 of the Social Security Act (42 U.S.C. 1397gg(e)(1)) is 

7 amended to read as follows: 

8 ‘‘(J) Paragraph (4) of section 1903(v) (re9 lating to lawfully present individuals).’’. 

10 (c) EFFECTIVE DATE.— 

11 (1) IN GENERAL.—Except as provided in para12 graph (2), the amendments made by this section 

13 shall take effect on the date of the enactment of this 

14 Act and shall apply to services furnished on or after 

15 the date that is 90 days after such date of the enact16 ment. 

17 (2) EXCEPTION IF STATE LEGISLATION RE18 QUIRED.—In the case of a State plan for medical as19 sistance under title XIX, or a State child health plan 

20 under title XXI, of the Social Security Act which the 

21 Secretary of Health and Human Services determines 

22 requires State legislation (other than legislation ap23 propriating funds) in order for the plan to meet the 

24 additional requirements imposed by the amendments 

25 made by this section, the respective State plan shall 


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1 not be regarded as failing to comply with the re2 quirements of such title solely on the basis of its 

3 failure to meet these additional requirements before 

4 the first day of the first calendar quarter beginning 

5 after the close of the first regular session of the 

6 State legislature that begins after the date of the en7 actment of this Act. For purposes of the previous 

8 sentence, in the case of a State that has a 2-year 

9 legislative session, each year of such session shall be 

10 deemed to be a separate regular session of the State 

11 legislature. 

12 SEC. 4. CONSISTENCY IN HEALTH COVERAGE FOR INDIVID13 UALS GRANTED DEFERRED ACTION. 

14 (a) IN GENERAL.—For the purposes of eligibility 

15 under any of the provisions referred to in subsection (b), 

16 all individuals granted deferred action shall be considered 

17 to be lawfully present in the United States. 

18 (b) PROVISIONS DESCRIBED.—The provisions de19 scribed in this subsection are the following: 

20 (1) EXCHANGE ELIGIBILITY.—Section 1311 of 

21 the Patient Protection and Affordable Care Act (42 

22 U.S.C. 18031). 

23 (2) REDUCED COST-SHARING ELIGIBILITY.— 

24 Section 1402 of the Patient Protection and Afford25 able Care Act (42 U.S.C. 18071). 


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1 (3) PREMIUM SUBSIDY ELIGIBILITY.—Section 

2 36B of the Internal Revenue Code of 1986. 

3 (4) MEDICAID AND CHIP ELIGIBILITY.—Titles 

4 XIX and XXI of the Social Security Act, including 

5 under section 1903(v) of such Act (42 U.S.C. 

6 1396b(v)). 

7 (c) EFFECTIVE DATE.— 

8 (1) IN GENERAL.—Subsection (a) shall take ef9 fect on the date of the enactment of this Act. 

10 (2) TRANSITION THROUGH SPECIAL ENROLL11 MENT PERIOD.—In the case of an individual de12 scribed in subsection (a) who, before the first day of 

13 the first annual open enrollment period under sub14 paragraph (B) of section 1311(c)(6) of the Patient 

15 Protection and Affordable Care Act (42 U.S.C. 

16 18031(c)(6)) beginning after the date of the enact17 ment of this Act, is granted deferred action de18 scribed in subsection (a) and who, as a result of 

19 such subsection, qualifies for a subsidy described in 

20 paragraph (2) or (3) of such subsection, the Sec21 retary of Health and Human Services shall establish 

22 a special enrollment period under section 

23 1311(c)(6)(C) of such Act during which such indi24 vidual may enroll in qualified health plans through 

25 Exchanges under title I of such Act and qualify for 


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1 such a subsidy. For such an individual who has been 

2 granted deferred action as of the date of the enact3 ment of this Act, such special enrollment period 

4 shall begin not later than 90 days after such date 

5 of enactment. Nothing in this paragraph shall be 

6 construed as affecting the authority of the Secretary 

7 to establish additional special enrollment periods 

8 under section 1311(c)(6)(C) of the Patient Protec9 tion and Affordable Care Act (42 U.S.C. 

10 18031(c)(6)(C)). 

Æ 


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