Immigrant Populations Could Pose Challenges for Medicaid Expansion
States that are home to high numbers of undocumented and recent immigrants could face greater challenges than other states in expanding Medicaid under the Affordable Care Act, according to a recent analysis of U.S. Census Bureau data by the Robert Wood Johnson Foundation, Modern Healthcare reports (Barr, Modern Healthcare, 3/19).
During the health reform debate in 2010, Democrats pledged to block undocumented immigrants from obtaining health benefits under the ACA. President Obama renewed that pledge when he released his immigration reform plan in January (California Healthline, 2/13).
Under Obama's plan, many of the estimated 11 million undocumented immigrants in the U.S. would be offered a "provisional" or "probationary" status, but those individuals would not be eligible for the ACA's benefits (California Healthline, 1/30). According to Modern Healthcare, most state Medicaid programs generally exclude immigrants who have been living in the U.S. legally for less than five years.
Findings From RWJF Analysis
According to the analysis, some states have relatively higher proportions of undocumented and recent immigrants in the pool of adults under age 65 who are expected to gain Medicaid coverage in 2014.
For example in Nevada, 34% of potential recipients of Medicaid coverage under the expansion are immigrants who will not qualify. In addition, the analysis found that:
- In Arizona, 31% of potential recipients would be ineligible for Medicaid;
- In California and Texas, 26% would be ineligible;
- In Missouri and Louisiana, only 4% would be ineligible; and
- In Mississippi, just 3% would not qualify.
The analysis concluded, "Safety-net health care providers are likely to continue to be key providers for this population after health reform, and the need for safety-net care will not be spread evenly across states" (Modern Healthcare, 3/19).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.