Mobilizing health workers for the protection of human rights and the promotion of the right to health

USA: Effects of recent policies on the right to health

January 24, 2018

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Please see below two examples of how recent U.S. policies under the Trump administration seriously affect the right to health of American citizens:

1) A large number of legal immigrants from Latin American countries have dropped out of federally subsidized insurance plans and are avoiding health services. They fear their information could be used to identify and deport relatives living in the U.S. illegally.

2) The Trump administration is planning new protections for health workers who refuse to perform abortions, treat transgender patients based on their gender identity, or provide other services for which they have moral objections. This raises fears among health and human rights advocates that this new policy will provide legal cover for unlawful discrimination.

Polarized immigration debate

After Trump became president a year ago, “every single day families canceled” their Medicaid plans and “people really didn’t access any of our programs,” said Daniel Bouton, a director at the Community Council, a Dallas nonprofit that specializes in health-care enrollment for low-income families.

The trend stabilized a bit as the year went on, but it remains clear that the increasingly polarized immigration debate is having a chilling effect on Hispanic participation in health-care programs, particularly during the enrollment season that ended in December.

Bouton’s organization has helped a 52-year-old housekeeper from Mexico, a legal resident, sign up for federally subsidized health insurance for two years. But now she’s going without, fearing immigration officials will use her enrollment to track down her husband, who is in the country illegally. She’s also considering not re-enrolling their children, 15 and 18, in the Children’s Health Insurance Program, or CHIP, even though they were born in the U.S.

“We’re afraid of maybe getting sick or getting into an accident, but the fear of my husband being deported is bigger,” the woman, who declined to give their names for fear her husband could be deported, said through a translator in a telephone interview.

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Prioritizing religious liberty over people

The U.S. Department of Health and Human Services created a new Conscience and Religious Freedom Division within its Office of Civil Rights to enforce the rights of doctors, nurses and others who invoke such objections.

Critics of the move predicted the new division, whose creation was praised by conservative Christian advocacy groups that have strongly supported Republican President Donald Trump, would become embroiled in current litigation over whether health-care workers can deny care to women seeking abortions or birth control as well as gay and transgender patients.

“We may not know exactly what this new division will look like in practice, but we do know that this means they prioritize religious liberty over women, transgender people and others,” said Louise Melling, the American Civil Liberties Union’s deputy legal director.

Jack Ende, president of the American College of Physicians, said the second-largest U.S. doctors group “would be particularly concerned if the new HHS division takes any actions that would result in denial of access to appropriate healthcare based on gender, gender identity, sexual orientation, race, ethnicity or other personal characteristics.”

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