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Affordable access to care for the undocumented
Insights
Excluding undocumented immigrants from the Affordable Care Act (ACA) denies essential health insurance. Expanding coverage could be cost-neutral due to increased tax revenue and reduced emergency care costs.
Area of Science:
- Public Health
- Health Policy
- Immigration Studies
Background:
- The Affordable Care Act (ACA) excludes nearly 12 million undocumented immigrants, including millions of children, from accessing state and federal health insurance exchanges.
- This exclusion denies access to affordable and reliable healthcare, sending a message that their well-being is not a societal priority.
Purpose of the Study:
- To analyze the implications of excluding undocumented immigrants from health insurance exchanges.
- To evaluate the potential financial impact of extending healthcare access to undocumented populations.
Main Methods:
- Review of existing healthcare policy, specifically the Affordable Care Act.
- Analysis of a recent study from California examining the costs and benefits of expanding state-supported care to undocumented immigrants.
Main Results:
- Extending ACA marketplace access and subsidies to undocumented immigrants would necessitate additional funding.
- A California analysis suggests that increased state sales tax revenue from managed care organizations and decreased county spending on uninsured emergency care could offset expansion costs.
Conclusions:
- The exclusion of undocumented immigrants from the ACA represents a significant policy gap.
- Expanding health insurance access to undocumented immigrants may be financially viable, with potential cost offsets through economic contributions and reduced uncompensated care.
Abstract:
How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding. However, a recent analysis in California has found that the costs of expanding state-supported care to include undocumented immigrants would largely be offset by the increased state sales tax revenue paid by managed care organizations and by reduced spending at the county level on emergency-room and hospital care of the uninsured.
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