How Will the Affordable Care Act Affect Illegal Immigrants

The Supreme Court's landmark ruling on the Affordable Care Act last week cleared the way for its implementation. But as Nathan Bernier reports from Austin, there's one very large segment of the population for whom the new law will not apply. 


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Here’s how Senate Majority Leader Harry Reid reacted to last week’s ruling on the Affordable Care Act.

“Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality healthcare for every person in America.”

Well, maybe not every person. More than 10 million undocumented immigrants in the United States will be virtually untouched by the Affordable Care Act. Those same people are entitled to receive emergency health care, even if they can’t afford it, under a federal law passed during the Reagan administration. That costs the state and local hospital districts more than $800 million dollars a year, according to the Texas Health and Human Services Commission. These immigrants sitting in the waiting room of a low-cost medical clinic in Austin run by El Buen Samaritano Episcopal Mission said they would rather be able to buy affordable coverage through health insurance exchanges that go into effect in 2014.

Norma Barron: “I think it’s important to have health insurance because, well, if I could have it I’d take it because if I need it, it’s my health that’s on the line.”

Freddie Lainze: “I think the right to health and medical insurance shouldn’t be denied to any human being. Well, that’s my opinion.”

But excluding undocumented immigrants from health insurance exchanges is not exactly controversial, given the concern that it could encourage illegal immigration. You might remember this infamous exchange when President Obama was addressing Congress in 2009.

Obama: “There were also those who would claim that our reform efforts would insure illegal immigrants. This too is false. The reforms I am proposing would not apply to those who are here illegally.”

Barton: “You lie!” (Jeers)

Obama: “It’s not true.”

That was Republican Congressman Joe Wilson shouting “you lie” at the president. He later apologized for his outburst.

“It’s politically tortured territory to start working on access to care for undocumented folks.”

Anne Dunkelberg is with the Center for Public Policy Priorities, a progressive state policy think tank. She says the politics of immigration might be preventing us from saving money on health care.

“So having a big chunk of the population like the undocumented who stay outside the system it definitely works against the goals of the Affordable Care Act, getting to the most cost effective place we could be in our health care system.”

But opponents of the Affordable Care Act reject the premise that it would bring down costs at all. Alrene Wohlgemuth with the conservative Texas Public Policy Foundation.

Wohlgemuth: “What we need is a better immigration policy and we need to have health care reform that will actually lower the costs for everyone, and this bill is not it.”

Wohlgemuth says there are already numerous ways for illegal immigrants to access affordable health care such low cost clinics, Federally Qualified Health Centers and emergency Medicaid. About a third of undocumented immigrants have private health insurance, according to the Pew Hispanic Center. Many others are just paying doctors in cash.

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