Immigrants living in the U.S. illegally are almost twice as likely as U.S.-born residents to report making no doctor visit in the past year. And even with the implementation of the Patient Protection and Affordable Care Act, that doesn't seem apt to change unless President Barack Obama extends coverage to them when he issues an expected executive order attempting to reform U.S. immigration policy without Congress.
Obama is scheduled to announce his plans on immigration Thursday.
The estimated 11 million immigrants described by the Obama administration as “unauthorized” won't see much benefit from the health reform law, according to a study by researchers at the UCLA Center for Health Policy Research (PDF). While some may pick up employer-sponsored coverage, others are expected to lose it. And the expansion of Medicaid and creation of federal and state insurance exchanges does nothing to help them either—unauthorized immigrants are excluded from both.
As a result, the number and proportion of these immigrants living in the U.S. without insurance coverage is not expected to change much over the next several years. In 2012, 61% of them nationwide lacked insurance coverage. Four years later, that figure is predicted to be 61.5%.
The significant change is expected to come in terms of what portion of the overall uninsured population that this group will make up. Under a scenario in which Medicaid is fully expanded, immigrants living in the U.S. without permission may account for 24.5% of the uninsured population in 2016, a substantial increase from 9.5% in 2012. In states with the highest numbers of immigrants, that percentage is estimated to be even higher, the researchers said. For example, people who immigrated illegally could make up 41.0% of California's uninsured population in 2016.
So even as the numbers of uninsured people dwindle, safety net hospitals may continue to operate under a heavy burden of providing care for this largely uninsured group at the same time these hospitals are facing cuts in federal disproportionate-share hospital payments to help cover the costs of uncompensated care.
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