[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4240 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 4240

      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

                             March 13, 2014

   Ms. Michelle Lujan Grisham of New Mexico (for herself, Ms. Lee of 
California, Ms. Norton, Mrs. Christensen, Ms. Fudge, Mr. Gutierrez, Ms. 
  Roybal-Allard, Mr. Veasey, Mr. Cardenas, Mr. Grijalva, Ms. Brown of 
 Florida, Mr. Hastings of Florida, Ms. Linda T. Sanchez of California, 
Ms. Pingree of Maine, Ms. Schakowsky, Mr. Vargas, and Mrs. Napolitano) 
 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.

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

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 2014'' or as the ``HEAL 
Immigrant Women and Families Act of 2014''.

SEC. 2. 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 five 
        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.

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.'';
            (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 (J) of section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)) is amended to read as follows:
                    ``(J) 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. REMOVING BARRIERS TO HEALTH COVERAGE FOR INDIVIDUALS GRANTED 
              DEFERRED ACTION FOR CHILDHOOD ARRIVALS.

    (a) In General.--For the purposes of eligibility under any of the 
provisions referred to in subsection (b), individuals granted deferred 
action under the Deferred Action for Childhood Arrivals process of the 
Department of Homeland Security, as described in the memorandum of the 
Secretary of Homeland Security on June 15, 2012, shall be considered 
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 deferred action 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 deferred 
        action 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)).
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