This past year, Loyola University’s Stritch School of Medicine made the bold move to become the first medical school in the nation to openly welcome applications from students with status under the Deferred Action for Childhood Arrivals (DACA) program. The DACA program, launched by President Obama in June 2012, provides temporary status for two years and employment authorization to immigrant youth who were brought to the United States as children. DACA has allowed hundreds of thousands of young people – who grew up in the United States, were educated here, and know no other home – to live without fear of imminent deportation, to receive a social security number, and to continue contributing to their communities. Loyola’s decision gives this group of talented and deserving American youth the opportunity to advance their dreams of becoming medical professionals.
Ensuring that these young people will eventually be able to obtain medical licenses is an important issue for advocates. After all, many young people with DACA want to give back to the communities here in the United States where they grew up, communities that are often underserved. This would mean lots of new, passionate physicians providing essential health services in disadvantaged communities.
A crucial question, then, is what are the legal barriers to obtaining a medical license for a physician with DACA?
Medical licensure is administered at the state level, and as such, the requirements to obtain a medical license vary from state to state. At present, many state medical licensing boards do not affirmatively request information regarding citizenship status. This includes the medical licensing board in Illinois, where Loyola’s medical school is located.
Some states, however, do require information on citizenship. In particular, Arizona requires the completion of a two-page form (the “Arizona form”) devoted entirely to an applicant’s status under U.S. immigration law, and it is not clear if DACA holders would qualify under any of the options offered on the state’s medical license application. One option, “Otherwise Lawfully Present” appears at first pass to be an acceptable option, given guidance from the U.S. Department of Homeland Security on the issue of lawful presence. However, it is unclear this option would be sufficient due to limitations presented by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (the “Welfare Reform Act”). The Welfare Reform Act prohibits certain categories of individuals from receiving “public benefits,” defined to include “any grant, contract, loan, professional license, or commercial license provided by an agency of a State or local government or by appropriated funds of a State or local government.” The Arizona form makes clear that Arizona considers medical licensure to fit within this definition. Under the Welfare Reform Act, the categories of individuals eligible to receive such benefits include “qualified aliens” and “nonimmigrant aliens,” and individuals with DACA do not fit squarely into either of these categories (perhaps, in part, because DACA did not exist in 1996 when Welfare Reform was signed into law).
The Welfare Reform Act creates obstacles that extend beyond medical licenses. In particular, the Welfare Reform Act has popped up in several states recently in litigation related to professional licensure of attorneys. When Sergio Garcia, an undocumented law school graduate, sought to receive a law license in California last fall, the California Supreme Court indicated its reluctance due to the Welfare Reform Act. However, Justice Marvin Baxter of the California Supreme Court offered from the bench that the Welfare Reform Act would not be a barrier if the State of California passed legislation to add undocumented individuals as a category eligible to receive specified public benefits under the Welfare Reform Act. Indeed, individual states can increase the number of groups that can receive public benefits under the Welfare Reform Act through state legislation. Following this, the California legislature wasted little time and passed legislation permitting undocumented individuals to be eligible to become licensed attorneys, and in January of this year, the California Supreme Court admitted Mr. Garcia to the bar.
Meanwhile in Florida, the state’s highest court ruled unanimously in March that Jose Godinez-Samperio, a DACA-eligible law school graduate, was ineligible for a state law license. The Florida Supreme Court, despite going to extensive lengths to explain its frustration with not being able to admit Mr. Godinez-Samperio, nonetheless concluded that its hands were tied due to the Welfare Reform Act and because the State of Florida had not yet passed legislation similar to what was passed in California.
Whether Arizona is the beginning of a trend in restricting medical licenses is yet to be seen. But what is clear from the California case and from the statements of the Florida Supreme Court justices is that legislatures can act affirmatively to ensure the Welfare Reform Act does not prevent individuals from obtaining professional licenses. We should be prepared to push for such legislation in states where medical boards show a reluctance to provide medical licenses based on DACA status. Alternatively, comprehensive immigration reform should provide for permanent legal status so that those with temporary status like DACA are no longer left in limbo.
In the meantime, as thousands of immigrant youth become eligible to re-apply for DACA this summer, now is prime time to be contemplating the future of these young people. It will be four years before the first Loyola DACA physicians graduate. We must make sure that these talented young people will not be prevented from putting their training to good use.
Chad R. Doobay is a member of the National Immigrant Justice Center’s Leadership Board, a pro bono attorney with NIJC, and an attorney at Katten Muchin Rosenman LLP in Chicago.
Image courtesy Tulane Public Relations via Wikimedia Commons.