The Senate appears close to passing its immigration reform bill, S. 744, by a large bipartisan majority. But despite heated claims to the contrary, the 2010 health care reforms play only a minor role in the legislation. Even if S. 744 became law tomorrow, the roughly 11 million undocumented immigrants who suddenly found themselves on a pathway to U.S. citizenship wouldn’t be able to access key elements of the Affordable Care Act (ACA) for well over a decade.
Those who gain status as “registered provisional immigrants” (RPI) would have to wait 10 years before being eligible for the ACA’s tax subsidies to purchase coverage on the insurance exchanges and up to 15 years to be eligible for the ACA’s expanded Medicaid program. And it could take another two years just to get the law implemented.
On the other hand, RPIs would still be eligible to purchase insurance at full price on the exchanges. And they will continue to be covered for a limited set of procedures through the Emergency Medicaid program. RPIs also would not be required to purchase insurance under the ACA’s individual mandate.
Some immigration reform advocates see the lack of access to coverage as a significant flaw in the bill.
Health insurance will continue to remain unaffordable to most RPIs, and these individuals will likely remain uninsured, says Sonal Ambegaokar, a health policy attorney for the National Immigration Law Center, which advocates for reform. “You’re sort of shooting yourself in the foot for denying them health care access for 10 years,” she says. “They’re going to get sicker and sicker, and then they’re going to enter the system, and we’re not really helping ourselves.”
Others take a different view. Rep. Raul Labrador (R-Idaho), a House negotiator on immigration, warned recently that “Obamacare” might be the one factor that “killed immigration reform” in the end. “The American people are not going to be responsible for the health care costs of the people that are here illegally,” he said, according to POLITICO.
But Ambegaokar says the rhetoric around health care and immigration reform is more intense than what actually is at play. The argument that immigrants are going to come in and get all of these benefits is not based on evidence, she contends. “The Democrats have already tried to take health care off the table by excluding immigrants in all possible ways,” she says.
http://aishealth.com/blog/health-reform/senate-poised-pass-immigration-reform-bill-blocks-immigrants-tapping-aca
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