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Will Unauthorized Immigrants Get Federal Health Benefits After Reform?

Above: Wesley Community and Health Center in Phoenix currently serves mostly uninsured patients.

Audio

Aired 4/5/13


About 48 million Americans lack medical insurance. That’s poised to change next year when federal tax credits for insurance and expanded access to Medicaid become available to certain Americans under the Affordable Care Act.

But there’s a huge group left out -- the 11 million immigrants in the country illegally are currently barred from both programs.

— About 48 million Americans lack medical insurance. That’s poised to change next year when federal tax credits for insurance and expanded access to Medicaid become available to certain Americans under the Affordable Care Act.

But there’s a huge group left out -- the 11 million immigrants in the country illegally are currently barred from both programs.

One of those who is ineligible is 19-year-old Maria Diaz. She was born in Mexico and grew up in Arizona without papers. Her young life so far hasn’t involved many encounters with doctors.

“We didn’t have like extra money to just throw out if I broke something,” Diaz said. “So as a child I actually took precautions of trying not to hurt myself or get sick or break bones.”

Due to the Obama administration’s deferred action program for young immigrants, Diaz recently got a work permit and is now working.

But her new minimum wage job babysitting at a gym doesn’t come with benefits.

“At this point in my life I still don’t have health insurance or someone to go to if I don’t feel good,” Diaz said. “I would have to take a second thought about actually going anywhere because of how much it would cost.”

Unauthorized immigrants — including young immigrants who were brought as children and qualified for deferred action like Diaz — will be barred from buying insurance under the new health care exchanges that the Affordable Care Act will create next year.

Those immigrants are also barred from Medicaid. That program currently only accepts U.S. citizens, legal permanent resident who have had that status for more than five years, refugees and very specific categories of humanitarian immigration cases.

But could that change with immigration reform?

Florida Senator Marco Rubio, one of the so-called “Gang of Eight” senators drafting immigration reform legislation, told Rush Limbaugh earlier this year that federal health benefits could jeopardize a deal.

“If Obamacare is available to 11 million people, it blows a hole in our budget and makes this bill undoable,” Rubio said. “That's one of the major issues we're going to have to confront. “

Adding these immigrants under the Affordable Care Act would cost billions, and would mean expanding a program that many Republicans already want to repeal.

Forthcoming immigration reform proposals are expected to grant those here illegally some kind of provisional legal status which will require they wait several years, likely 10 to 15, for various federal health benefits. That path could be shorter for young immigrants like Diaz who were brought here illegally as children.

But there are also huge costs to leaving these immigrants uninsured for several years.

“Since all of us now are required to pay for insurance under the Affordable Care Act, it is better for us to have immigrants in the pool,” said Sonal Ambegaokar of the National Immigration Law Center.

“Because if there are more people in the pool, especially those who are younger and healthier, which immigrants generally are, then our individual premium costs will go down.”

Ambegaokar said insuring these immigrants would help reduce expensive emergency room visits, which shifts the cost to the state and local level.

It’s worth mentioning that not every immigrant in the country illegally and awaiting immigration reform is uninsured. An estimated 40 percent actually have health insurance -- most of them through their jobs, according to the Migration Policy Institute.

Maria Diaz says she tries to avoid getting sick because she is currently uninsured.

The rest though, in the absence of federal benefits, will likely rely on safety net health providers.

One such place is the Wesley Community and Health Center in South Central Phoenix that serves low income patients.

“Our insured patients total 12 percent of our patient population, so that means 88 percent of our patients are uninsured,” said Betty Mathis, who runs the center.

These kinds of clinics all over the country are bracing for increased demand next year as more low-income people qualify for Medicaid and start using medical services

But they will also be one of the only options for the uninsured.

Randy Capps with the Migration Policy Institute says these safety net providers might be overwhelmed, especially in states with a high immigrant population.

“The currently unauthorized population — and that is the population that would legalize under immigration reform — is heavily concentrated in the Southwest,” Capps said. “So those states are most at risk for pressure on their safety net health care systems.”

Arizona, Nevada, California and Texas have the highest share of uninsured, poor adults who won't get Medicaid because of immigration status, according to estimates by the Robert Wood Johnson Foundation.

Adding to the strain, hospitals, the ultimate safety net, will be receiving fewer federal dollars to treat uninsured patients.

But there is a potential fix, according to Capps.

“The last legalization law, way back in 1986, provided state grants to help cover health care costs for legalizing immigrants,” Capps said. “These kinds of grants are being discussed again in immigration reform.”

Maria Diaz, the uninsured 19-year-old, questioned the long-term savings of leaving people out of the Affordable Care Act who are on a path to remaining in the country permanently.

“Maybe once they are documented, their health conditions have increased to the extent that once they are a citizen or a resident, you have to pay even more for those problems,” Diaz said.

Comments

Avatar for user 'JeanMarc'

JeanMarc | April 10, 2013 at 10:13 a.m. ― 1 year, 6 months ago

Why not. Give them healthcare, housing, lets just give them everything and let this country go to hell.

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 10, 2013 at 10:44 a.m. ― 1 year, 6 months ago

"It’s worth mentioning that not every immigrant in the country illegally and awaiting immigration reform is uninsured. An estimated 40 percent actually have health insurance -- most of them through their jobs"

===

Employing illegal aliens is a felony under Sec. 274. [8 U.S.C. 1324].

Is there any difference in violating federal immigration laws and federal revenue laws?

How about we citizens take a lesson from illegal aliens and their employers and we all just stop paying taxes? Why should we be punished but not them?

Can anyone answer that question?

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 10, 2013 at 11:05 a.m. ― 1 year, 6 months ago

JeanMarc,

I agree. I've already lost faith in the US as it can't be pulled out of its downward spiral.

I'm trying my best to defend California and believe if all her people pull together we can save her. No matter how daunting and difficult that task is, I think she's worth it.

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Avatar for user 'Peking_Duck_SD'

Peking_Duck_SD | April 10, 2013 at 4:59 p.m. ― 1 year, 6 months ago

I can see the media doesn't agree with Peking Duck!

I suggested the "new" term to use instead of illegal immigrant be "non-naturalized immigrant".

Using "Unauthorized immigrant" has many of the same problems and negative connotations as "illegal immigrant" does.

If I am an "unauthorized" person at my place of employment, I will be escorted off by security.

Non-naturalized references the term used to indicate full citizenship, I think it's much better.

But nobody who makes these sweeping decisions asked me, so I guess I should just keep my bill shut ;)

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Avatar for user 'Peking_Duck_SD'

Peking_Duck_SD | April 10, 2013 at 5:04 p.m. ― 1 year, 6 months ago

Jean and CF - the U.S., like most Western European countries and Japan, is aging and immigrants will actually be a bennefit to our country as they will allow a young workforce to be maintained.

Look at Japan - they are facing an looming crisis with their population shifts, they will likely have to encourage immigrants to come and work there much like small nations in the Middle East have had to bring in migrants from the South Asian subcontinent to even out their labor force.

Don't you think our ridiculous immigration policies that have an extremely unrealistic legal process need to be modified to allow for needed worker immigration to our country?

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 11, 2013 at 10:31 a.m. ― 1 year, 6 months ago

JEAN MARC, calm down.

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 11, 2013 at 10:36 a.m. ― 1 year, 6 months ago

Offender is trying to "defend" California. From this days of this:

The Lemon Grove Incident | San Diego History Centerwww.sandiegohistory.org/journal/86spring/lemongrove.htmCached - SimilarShare
Shared on Google+. View the post.
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Seventy-five of these children attended the Lemon Grove Grammar School where a ... Dejected, embarrassed and angry, the Mexican children left the school and ..... LULAC appealed the decision to the U.S. Supreme Court, but the case was

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 11, 2013 at 10:43 a.m. ― 1 year, 6 months ago

The Public Spends Little to Provide Health Care for Undocumented ...www.rand.org › ... › Research Briefs › RB-9230Cached - SimilarShare
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Mar 1, 2010 – He publishes widely on issues of immigration and health. ... largest concentration of immigrants in the nation, RAND Corporation researchers analyzed ... Of the $430 billion in national medical spending in 2000, native-born

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 11, 2013 at 10:58 a.m. ― 1 year, 6 months ago

Duck,

As I mentioned before, the correct term is illegal alien.

"Non-naturalized immigrant" implies an illegal alien has some legal standing such as a work, study, or tourist visa when they do not. It also implies they have properly applied for citizenship when they have not.

Illegal alien correctly identifies their legal standing and immigration status.

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 11, 2013 at 11:26 a.m. ― 1 year, 6 months ago

Duck,

I disagree. We don't need more young laborers to work in America's fields and factories. We have enough, they're just too lazy to do it.

What we do need a streamlined process for temporary foreign workers to obtain permits and for companies to easily employ them. This would help us utilize temporary foreign workers where and when we need them.

It also protects those workers from labor abuses which are all too common now. Most illegal aliens live a life that resembles a slave. We have a moral obligation to elevate them to the status of a legal worker and prevent/punish companies who abuse them.

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Avatar for user 'benz72'

benz72 | April 11, 2013 at 12:53 p.m. ― 1 year, 6 months ago

MA, those comments are a bit tough to decipher. Would you please repost more clearly?

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 12, 2013 at 9:10 p.m. ― 1 year, 6 months ago

CA,

"Alien" implies the anachronistic and discriminatory pre-1965 Quota era.

And HOW do you get lazy people to work??? Do you SERIOUSLY think it is laziness--or is it the conditioning that the more formal education a person has--the less likely he or she is to perform manual work--LET ALONE stoop labor. How are you on stoop labor, CA?

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 12, 2013 at 9:14 p.m. ― 1 year, 6 months ago

Cixelsid much Benz??? But serioulsy, key in the 2006 Rand Corp Study in Google about the health costs

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 13, 2013 at 10:59 a.m. ― 1 year, 6 months ago

Mission,

"Alien" is the appropriate legal term and has no such connotation as you described.

It is COMMONLY used in state and federal legal cases, presidential executive orders, law schools (including Harvard, Yale, Stanford, Columbia, and Cornell), US Citizenship and Immigration Services, Department of State, and Department of Homeland Security, Merriam-Webster Dictionary, and Oxford Dictionary.

You, and some in the media (including KPBS), are injecting personal and political bias by intentionally scrambling and blurring definitions to fit your narrow agenda. That is pure propaganda.

It is like renaming torture "advanced interrogation".

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Avatar for user 'CaliforniaDefender'

CaliforniaDefender | April 13, 2013 at 11:12 a.m. ― 1 year, 6 months ago

Also Mission, do you think education "conditioning" makes a person above manual labor? That is quite an arrogant statement.

With an actual unemployment rate exceeding 11% in the US, we shouldn't have a shortage of manual laborers. Manual labor is a paying job and those who voluntarily choose unemployment over manual labor are lazy and burdens upon the state.

How do you get lazy people to work? Reduce entitlement programs. That's how.

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Avatar for user 'Anon11'

Anon11 | April 13, 2013 at 5:40 p.m. ― 1 year, 6 months ago

It amazes me people will complain about undocumented immigrants getting benefits, instead of complaining about the fact our government can't manage to get the rest of us the same benefits.

Healthcare may have a surface level cost, but the secondary savings can be even greater. A society that is proactive about its health (instead of reactive like currently) is a positive both in the fact that people are able to receive proper care and screenings, and in the fact that a healthy society doesn't get each other sick and create a cycle of illness.

Just like the prevalence of vaccines may have cost us initially, the savings became clear when we didn't have to treat people for smallpox or polio, and we were given a blanket of protection due to 'herd immunization'.

"With an actual unemployment rate exceeding 11% in the US, we shouldn't have a shortage of manual laborers. Manual labor is a paying job and those who voluntarily choose unemployment over manual labor are lazy and burdens upon the state."

I can agree with this, mostly. Although I don't feel manual labor is a realistic solution for every single currently unemployed person, I do know (anecdotal evidence, mind you) people that choose to collect welfare rather than put themselves out there for 40 hours, because they wouldn't make too much extra. That attitude is disgusting and a burden to the rest of us, for sure. But I'm not going to make sweeping generalizations, because social programs do a LOT of good for a LOT of people.

http://www.mercurynews.com/business/ci_22764267/california-farms-face-labor-shortage-farmworkers-age

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Avatar for user 'RegularChristian'

RegularChristian | April 15, 2013 at 6:56 a.m. ― 1 year, 6 months ago

I hope they get benefits. Seems like the Christian thing to do.

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Avatar for user 'benz72'

benz72 | April 15, 2013 at 7:03 a.m. ― 1 year, 6 months ago

Then perhaps the christians should provide those benefits.

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Avatar for user 'Anon11'

Anon11 | April 15, 2013 at 8:59 a.m. ― 1 year, 6 months ago

Seems like the human thing to do...

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 15, 2013 at 9:29 a.m. ― 1 year, 6 months ago

Ca Off, as is: illegal worker, undocumented immigrant, undocumented worker, clandestine border crosser: Princeton University, UCLA . . .

Well, when is the last time you did stoop labor, CA Off? It is people like yourself who are the Social Darwinists of the 21 st century and you're telling me that fact-based comment is "arrogant"? You know that's ALWAYS been the case. I'd like to see a laid off white anglo saxon professional (pick your field) work housekeeping in a hotel, gardening or construction at non-union wages. Not going to happen. Google those stories about domestic farmers not finding enough local help, or they hire young people and then they quit on them. Then we'll talk.

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Avatar for user 'benz72'

benz72 | April 15, 2013 at 10:45 a.m. ― 1 year, 6 months ago

If we stop subsidizing those laid off white anglo-saxon professionals with public funding this will change. When the choice is hunger or stoop labor the choice is easy.

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Avatar for user 'Missionaccomplished'

Missionaccomplished | April 15, 2013 at 8:23 p.m. ― 1 year, 6 months ago

1) You say so, but false pride is very strong, Benz.
2) Are they lazy out in the fields are standing in the sun all day outside a Home Depot? Is that laziness to you?
3) No comment on the Rand Corp study?
4)

Farmers scrambling to find harvest labor - SFGate
www.sfgate.com/.../Farmers-scrambling-to-find-harvest-labor-...ShareMay 27, 2012 – And farmers are saying this year is even worse. Growers have tried to hire more domestic workers and had hoped that with unemployment .
5) "undocumented alines are often reluctant to seek legal remedies for wrongs done to them or to apply for welfare services." -- James W. Nickell, in Brown & Shue, eds, THE BORDER THAT JOINS: Mexican Migrants and US Responsibility, (Rowman & Allanhand, 1983) p 43

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Avatar for user 'benz72'

benz72 | April 16, 2013 at 7:06 a.m. ― 1 year, 6 months ago

I'm not expecting people to work out of pride, but rather from self-interest. If your choice were hunger or work, what would you do? I'd rather be in a field scraping a living than starve to death.

I cannot comment on the links you are attempting to post because they do not connect.

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Avatar for user 'JeanMarc'

JeanMarc | April 16, 2013 at 12:13 p.m. ― 1 year, 6 months ago

Hey we don't need to do that benz, I won't starve to death. The government will take care of me. I don't even need to pay for health insurance. I will just enjoy a relaxing 96-weeks of unemployment checks.

I can't understand why people on the left are always offended by the truth. "Illegal immigrant" is a factual description of people who enter and remain in this country illegally. It's not a derogatory label. It is like "race car" or "blue sky", descriptions of objects.

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