Undocumented Immigrants, Left Out Of Health Reform, Likely To Continue To Grow As Share Of The Uninsured

Abstract

The increase in undocumented immigration between 1999 and 2007 contributed to an increase in the number of uninsured people in the United States. During this period, the number of undocumented immigrants increased from an estimated 8.5 million to 11.8 million, leading to an estimated additional 1.8 million uninsured. These uninsured and undocumented immigrants were estimated to represent 27 percent of the overall increase of 6.9 million uninsured people during this period. Undocumented immigrants accounted for one in seven of the uninsured in 2007, up from one in eight in 1999. These undocumented immigrants will not be eligible for public insurance or any type of private coverage obtained through exchanges under the Affordable Care Act of 2010. As a result, members of this group will eventually constitute a larger percentage of the uninsured population, unless other policy actions are taken to provide for their coverage, or their immigration status is changed.

Unauthorized Immigrants Prolong the Life of Medicare’s Trust Fund

“…3 In addition, the imputation procedure we used to estimate unauthorized immigrants' Medicare contributions and expenditures may have limitations, which have been described in other papers that have used this method. 11,12,40 However, given the limited availability of reliable data about the legal status of immigrants in large surveys, the imputation method we used appears reasonably reliable. A sensitivity analysis based on the estimated variation in size of the unauthorized population 41 suggests that unauthorized immigrants provided a subsidy of between $33.6 and $36.5 billion between 2000 and 2011.…”

Impact of the Affordable Care Act on Health Care Access and Utilization Among Latinos

“…While the ACA excludes specific noncitizen groups (ie, undocumented or legally authorized but in the country Ͻ5 years) from benefits, 26,37 some noncitizens do qualify for benefits, and their eligibility varies by state (eg, California allows the undocumented to participate in the Marketplace, and legally authorized immigrants who have been in the US Ͻ5 years can participate in Medicaid); thus noncitizens were included in the analyses.…”

“…Because the ACA excludes undocumented individuals from benefits, the impact of the ACA's implementation will be limited for this group. 26 Over time, a larger proportion of the remaining uninsured are likely to be undocumented. 27 Research in disparities in access to and utilization of health care by different Latino heritage groups has received limited attention in the period after ACA implementation.…”

Assessing Health Care Services Used By California’s Undocumented Immigrant Population In 2010

“…25 Undocumented immigrants are estimated to represent nearly one-quarter of the uninsured population post-ACA implementation, 26 and an increasing number will likely seek lowcost care in the safety-net system. 27 Safety-net providers are concerned that newly insured populations under the ACA will seek care from commercial providers, leaving federally qualified health centers and other safety-net providers with an increasingly higher proportion of undocumented immigrant patients. 27,28 The ACA has provided federal funds to increase health centers' number and capacity, but the predominance of undocumented immigrant patients may negatively affect political support for federal grants to these providers.…”