Immigrant Health

Immigrant Health

Current issues impacting immigrant health: Please find below our current priorities and issues affecting immigrant health.

Be counted! Participating in the 2020 U.S. Census is important because it will determine where the government will spend billions of dollars for the next 10 years. Thanks to our Supreme Court, the Census will not be able to ask about one's nationality OR immigration status.

Let's participate in the 2020 U.S. Census and make a difference. #countmein #masscounts

1. Our priority: Expanding Children’s Health Access


Expand Health Coverage for Children was introduced by Representative D. Rogers & Senator DiDomenico (H. 162/ S. 677) 


Currently, low-income immigrant children who are not otherwise eligible for MassHealth can access only very limited health coverage, which leaves them without adequate access to many services, including prescription drugs, mental health services, durable medical equipment, dental services, and emergency care. An Act to ensure equitable health coverage for children would expand MassHealth coverage to low-income children whose only barrier to accessing comprehensive coverage is their immigration status. Other states, including California, Washington, Oregon, Illinois, and New York have already enacted this policy.
2. Public Charge Rule
Federal immigration uses a “public charge” test to determine who may be denied a visa or adjustment of status to lawful permanent residence (a “green card”). You may have heard about policy changes that could penalize immigrants for using some public benefits (government programs that may help you pay for food, housing or health care) and would make it more difficult for a family of 4 who earns less than $64,000 a year to obtain a green card. On February 24, 2020, the new “public charge” rule was implemented. However, many people are not subject to “public charge” or do not qualify for the benefits considered under the rule. Before making any decision regarding your use of benefits, please consult our factsheet:

HCFA has created a handout to help Massachusetts residents understand the rule and clear up common misconceptions. It is important that you understand the rule, determine whether it applies to you, and make informed decisions about health care options for you and your family.

Find the handout (English) here! You may find it in other languages here, including:

For fliers relating specifically to the use of SNAP and public charge, see the links below:
3. Deferred Action for Childhood Arrivals (DACA)
The DACA program was established by President Obama in 2012 and allows hundreds of thousands of young undocumented immigrants to live, work, and study in the US. Despite the current administration's many efforts to end the DACA program, it is still alive.

The DACA case is now before the Supreme Court! The Supreme Court is expected to rule sometime during the Summer of 2020 regarding the legality of the DACA program. But until then, DACA program recipients are able to, and should continue to, renew their DACA application.

Please refer to our partner, the Massachusetts Immigrant and Refugee Agency Coalition for more details at this link.
4. Temporary Protected Status (TPS)
TPS is a humanitarian designation assigned to people who cannot safely return to their home countries because of armed conflicts, natural disasters, epidemics, or other serious conditions. A country must be designated for TPS first, and then eligible nationals from that location have a limited amount of time to apply for the status. This designation allows people to work and receive benefits in the US. The current administration has sought to end TPS for a variety of countries, leading to several lawsuits. 
The following table provides information on TPS status by country:
Country Designation Date Expiration Date (If applicable) Employment Authorization Extended Through:
El Salvador March 9, 2011 Pending litigation January 4, 2021
Haiti July 23, 2011 Pending litigation January 4, 2021
Honduras January 5, 1999 Pending litigation January 4, 2021
Nepal June 24, 2015 Pending litigation January 4, 2021
Nicaragua January 5, 1999 Pending litigation January 4, 2021
Somalia September 18, 2012   September 17, 2021
Sudan May 3, 2013   January 4, 2021
South Sudan May 3, 2016 November 3, 2020 January 4, 2021
Syria October 1, 2016 March 31, 2021  
Yemen March 4, 2017 March 3, 2020 September 3, 2021


Please refer to our partner, the Massachusetts Immigrant and Refugee Agency Coalition for more details at this link.
5. Changes to the Asylum-Seeking Process
On March 5th, the Supreme Court blocked one of Trump administration's restrictions on the asylum-seeking process. The restriction was placed on individuals who did not first ask for asylum from the countries they traveled through while on their way to the United States. For example, if the restriction passed, a Honduran family crosses Guatemala and Mexico to get to the United States, they would have to file for asylum in Guatemala and Mexico before they are able to file for asylum in the United States. This restriction, which was blocked by the Supreme Court, would have effectively lengthened the wait time for thousands of asylum-seeking individuals. 

While Congress battles over immigration, former Attorney General Jeff Sessions did everything in his power to create unbearable burdens on undocumented immigrants in general and asylum seekers in particular. Sessions focused on dismantling and remodeling the wealth of policies, procedures, and memos that delineate the specifics about how the government carries out immigration enforcement.

Without fanfare, Sessions managed to implement harsher guidelines for children appearing in immigration court, limit the ability of immigration attorneys to seek continuances, curtail immigrants’ ability to transfer their case to a court closer to where they are living, and pack the immigration court benches with former ICE attorneys. Even though it actually caused more backlog, Sessions pulled immigration judges off their regular dockets and sent them to the southern border to decide the asylum claims of detained immigrants. Not content to leave asylum law in the hands of actual judges, Sessions also liberally utilized a provision in our immigration laws that allows him to refer immigration cases to himself. So far, his decisions in those cases have restricted judges’ ability to pause deportation proceedings, and gutted protections for victims of domestic and gang violence. 
6. Immigrant Detention and Family Separation
In January of 2020, Massachusetts attorney general Maura Healy joined a coalition of 20 other attorney generals around the country to support the federal court of appeals' injunction on Trump administration attempt to allow for indefinite detention of children.

The Trump administration has repeatedly tried to pass legislation that would allow for indefinite detention of immigrant children at the border. Although the federal court of appeals had placed an injunction on the bill, the injunction was lifted on August of 2019, and the bill passed for indefinite detention on children. The Democratic Party is looking to the Federal Courts of Appeals to place an injunction on the rule but have not yet been successful.  

The outcry over the zero-tolerance policy which led to families being torn apart at the border so parents could be detained and prosecuted led to President Trump issuing an executive order ostensibly halting it. While the order appears to put a stop to a heinous policy, it marks the beginning of another battle which is just as worrisome. Not only is the administration asking to detain families, but there is still concern over the health and whereabouts of children already separated from their parents.   

The disorganized implementation and dehumanization of the zero tolerance policy has exacerbated the health risks to immigrants who cross the border. A report released by the Human Rights Watch on June 20 details the risks to health in detention facilities, and this disturbing record of health care in detention facilities does not bode well for the safety of children the administration wants to detain.  

Our partners are working to reunite families in Massachusetts. The Brazilian Worker Center recently helped reunite a mother with her son. We applaud all efforts to quickly and efficiently bring children back to their parents.
7.  2020 Census Citizenship Question
In summer of 2019, the Supreme Court has blocked the citizenship question from appearing on the 2020 U.S. Census. The court decided that the Trump administration lacked sufficient evidence to justify the addition of a citizenship question to the U.S. Census. 

Since 2017, Trump administration has been working to add a question about citizenship status to the 2020 Census. We believed this would undermine the accuracy of the Census because immigrants (both with and without documentation) might refuse to fill out the form, thereby under-counting the immigrant population. This would then affect many decisions made by the government regarding allocation of public resources. Our partners at Community Catalyst sent out an action alert on the Census question which eloquently expresses the potential impacts of adding a question on the citizenship. We would like to thank the Senior State Advocacy Manager Alberto González for providing this action alert.

The proposal to add the citizenship question goes directly against the vital need to address the census’ historical undercounting of underserved communities. Adding this question discourages participation and threatens the accuracy of the count. The census, conducted every 10 years, provides data in determining fair political representation, directs the allocation of key resources to states, localities, and families, and helps businesses decide where to build and grow. 

The citizenship question has important implications on how hundreds of billions of dollars in federal funds for critical safety net programs are appropriated and delivered to states, including funding for Medicaid, the Children’s Health Insurance Program (CHIP), and the Supplemental Nutrition Assistance Program (SNAP). In FY2015, states received approximately $589.7 billion from 16 large federal financial assistance programs, with the allocations based on data from the 2010 Census.
8. Fear Impacting Health Access
As of Spring 2020, Health Care for Alll is teaming up with pro-immigrant groups such as the Massachusetts Immigrant and Refugees Advocacy (MIRA) Coalition and the Health Law Advocates (HLA) to pass a bill named the Safe Communities Act. This bill will ensure that no state police officers are pressured to act on behalf of the U.S. Immigration and Customs Enforcement (ICE). We believe that access to health care and other public benefits will be made easier by knowing that the government offocials in charge are not looking to turn people over to ICE.
In early 2017, medical providers and community organizations began reporting that immigrant patients were avoiding or delaying health care services due to fears of intensified immigration enforcement. Since that time, the federal government’s threatening rhetoric and actions toward immigrants – both perceived and actual – have further ratcheted up fear in our communities.

For resources, join or log into our Immigrant Health Toolkit!


About us:

Information about IHAC and the IHT.

1. About the toolkit ("IHT"):

The Immigrant Health Toolkit offers a range of health care-focused resources for organizations serving immigrant communities in Massachusetts. The idea for this Toolkit arose in early 2017 when medical providers and community organizations began reporting that immigrant patients were avoiding or delaying health care services due to fears of intensified immigration enforcement. Since that time, the federal government’s threatening rhetoric and actions toward immigrants – both perceived and actual – have further ratcheted up fear in our communities. The goal of the Immigrant Health Toolkit is to equip medical and social service providers with, 1) background information about immigrants’ legal rights, 2) resources for immigrants seeking legal and advocacy help, 3) up-to-date news about government actions affecting access to care or coverage, and 4) an entry point into campaigns that are fighting back.

2. About the Immigrant Health Access Committee ("IHAC"):

The Immigrant Healthcare Access Coalition (IHAC) brings together more than 80 organizations from across Massachusetts to advocate collectively for improvements in health care and coverage for immigrants. IHAC members represent a diverse array of expertise, from health care and immigration policy wonks and legal aid lawyers, to medical providers and community organizations delivering direct services to immigrant populations. The Coalition was founded in December 2014 by Health Law Advocates (HLA). In 2017, Health Care For All (HCFA) and the Massachusetts Immigrant and Refugee Advocacy Coalition (MIRA) joined HLA as members of the IHAC Steering Committee. During the past couple of years, we have focused on issues including preserving immigrants’ eligibility for MassHealth and the Health Connector, language access barriers, and access to long-term care services. Recently, we have turned our energies to developing the Toolkit and responding to proposed changes in “public charge” admissibility rules.

This project is possible thanks to commitments and funding from Jane's Trust, the Miller Foundation and the MetroWest Health Foundation.