I 
115TH CONGRESS 
1ST SESSION H. R. 2788 
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 
JUNE 6, 2017 
Ms. MICHELLE LUJAN GRISHAM of New Mexico (for herself, Mr. MCGOVERN, 
Mr. ESPAILLAT, Mr. TAKANO, Ms. MOORE, Mrs. NAPOLITANO, Ms. 
BONAMICI, Mr. GALLEGO, Mr. VEASEY, Ms. BARRAGA´N, Mr. GUTIE´RREZ, 
Ms. SCHAKOWSKY, Mrs. TORRES, Ms. ROYBAL-ALLARD, Mr. ELLISON, 
Mr. SOTO, Ms. CLARKE of New York, Ms. PINGREE, Ms. WILSON of 
Florida, Ms. NORTON, Mr. GRIJALVA, Mr. SERRANO, Ms. CLARK of Mas-
sachusetts, Ms. JAYAPAL, Ms. HANABUSA, Mr. JOHNSON of Georgia, Mr. 
HASTINGS, Ms. SA´NCHEZ, Ms. LOFGREN, and Ms. LEE) introduced the 
following bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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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 in-
creasing utilization of basic preventive health serv-
ices, 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 re-
strictions on their ability to obtain health insurance 
coverage through Medicaid, CHIP, and Health In-
surance Exchanges. 
(3) Lack of health insurance contributes to per-
sistent disparities in the prevention, diagnosis, and 
treatment of negative health outcomes borne by im-
migrants and their families. 
(4) Immigrant women are disproportionately of 
reproductive age, low-income, and lacking health in-
surance coverage. Legal barriers to affordable health 
insurance coverage therefore particularly exacerbate 
their risk of negative sexual, reproductive, and ma-
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ternal health outcomes, with lasting health and eco-
nomic consequences for immigrant women, their 
families, and society as a whole. 
(5) Denying coverage or imposing waiting peri-
ods for coverage unfairly hinders the ability of immi-
grants to take responsibility for their own health 
and economic well-being and that of their families. 
To fully and productively participate in society, ac-
cess 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. In-
deed 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 insur-
ance coverage based on immigration status. 
(7) Although Deferred Action for Childhood Ar-
rivals (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 
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Services, including Medicaid and the Children’s 
Health Insurance Program (CHIP). 
(8) Immigration law is constantly evolving and 
new immigration categories for individuals with fed-
erally 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 Se-
curity 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 Oppor-
tunity 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 med-
ical assistance under the State plan approved under this 
title (other than the requirement of the receipt of aid or 
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‘‘(M) Paragraph (4) of section 1903(v) (re-
lating to lawfully present individuals).’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (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 enact-
ment. 
(2) EXCEPTION
IF
STATE
LEGISLATION
RE-
QUIRED.—In the case of a State plan for medical as-
sistance 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 ap-
propriating 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 re-
quirements 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 en-
actment of this Act. For purposes of the previous 
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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 INDIVID-
UALS WITH FEDERALLY AUTHORIZED PRES-
ENCE, 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 con-
sidered to be lawfully present in the United States. 
(b) PROVISIONS DESCRIBED.—The provisions de-
scribed 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 Afford-
able 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 
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under section 1903(v) of such Act (42 U.S.C. 
1396b(v)). 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subsection (a) shall take ef-
fect on the date of the enactment of this Act. 
(2) TRANSITION
THROUGH
SPECIAL
ENROLL-
MENT
PERIOD.—In the case of an individual de-
scribed in subsection (a) who, before the first day of 
the first annual open enrollment period under sub-
paragraph (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 enact-
ment of this Act, is granted federally authorized 
presence in the United States described in sub-
section (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 dur-
ing 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 in-
dividual 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 
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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 Protec-
tion 
and 
Affordable 
Care 
Act 
(42 
U.S.C. 
18031(c)(6)(C)). 
Æ 
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