After years of postponing the inevitable, the U.S. is finally on the verge of reforming our dysfunctional immigration policies. For millions of immigrant families who have committed themselves to building better lives for themselves and their communities, change cannot come too soon. And for the children in these families, their hopes for the future are very much part of America's future.
Immigrant children are highly vulnerable. Their level of disadvantage and fragility has consistently grown due to factors outside their control. This population was explicitly excluded from the benefits of the president's health reform initiative.
With the leadership of President Obama and an unusual level of bipartisan Congressional collaboration, the Senate recently released a promising vision for reform. So what will immigration reform look like? And how will kids fare with proposals now on the table?
At the moment, while many historic changes in immigration policy are on the table, making sure all children get access to health care is not. Right now too many children simply aren't getting the care they need. So immigration reform needs to eliminate any and all barriers to needed medical care for kids, regardless of immigration status.
Even after the Affordable Care Act (ACA) is fully implemented, nearly a million non-citizen kids -- enough to fill a line of yellow school buses extending all the way from New York City to Washington, DC -- will be excluded from insurance coverage through no fault of their own. They are explicitly prohibited from being enrolled in federally funded programs like Medicaid and the Child Health Insurance Program -- or CHIP.
Of course, having insurance doesn't guarantee good health outcomes, but it is a critical factor. Insured children are more likely to have minor medical problems treated before they become serious illnesses and greater access to preventive care -- like vaccinations to prevent communicable diseases.
As Congress moves forward with efforts to reform immigration, quality health care should be made available to all kids. The next generation -- regardless of where they or their parents happen to have been born -- must have the opportunity to be healthy and successful.
How do we do this? All children should have access to the ACA's coverage expansions and affordability supports. Children who are on special tracks that ultimately allow them to have public health insurance should be given access to these programs immediately.
And all states should adopt the federally-funded option to lift the Medicaid and CHIP five-year ban for all immigrant kids, regardless of status. Benefit eligibility rules should match those that apply to citizens. Stricter enforcement of civil rights law should provide assistance to individuals with limited English proficiency.
While many elements of immigration reform have been controversial, ensuring that every child in America has a chance to learn, play, and grow into a healthy and productive adult is not. Let's give all kids the health care coverage and services they need. Doing so will ensure greater well-being not just for them, but for our nation as a whole.
Follow Irwin Redlener, M.D. on Twitter: www.twitter.com/IrwinRedlenerMD