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Left out: immigrants and health-care reform

Left out: immigrants and health-care reform

Picture of CALLIE  SHANAFELT

Undocumented immigrants and lawfully present immigrants who’ve been here less than five years are the largest group excluded from health-care reform.  They are not eligible to purchase insurance through the state exchanges and will continue to be excluded from Medicaid.

If the objective of the Affordable Care Act is to cut health-care costs by expanding the pool of the insured and reducing emergency room visits, excluding immigrants is counter-productive argues immigration reform advocate Sonal Ambegaokar.  Co-author of the ACA, Representative George Miller says they had to include the immigration exclusion because of all those opposed to spending federal dollars on undocumented immigrants.

Of the more than seven million currently uninsured California residents more than four million will remain uninsured after the implementation of the Affordable Care Act according to a UC Berkeley-UCLA report released in September. More than a quarter of them will not qualify for expanded Medicaid or insurance subsidies because of immigration status. 

But possibly even more troubling is that nearly a million more will qualify but not realize it. The report predicts that two thirds of the remaining uninsured will be Latino. Many of these are lawfully present residents living in “mixed status” families. 

Safety net clinics and hospitals serving these populations are also concerned that they will be disproportionately affected as money to cover the uninsured is cut on the premise that more residents have insurance.

I'm honored to be a part of the 2013 California Endowment Health Journalism Fellowship.  For my project I will report on what the immigration clause means for those excluded as well as for the health-care safety net. 

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