Obama’s Plan Would Bar ‘Provisional’ Immigrants From ACA Benefits
President Obama on Tuesday released hisÂ immigration reform plan, which would prevent immigrants with provisional legal status from gaining access to health benefits under the Affordable Care Act, including insurance exchanges, related subsidies and Medicaid,Â Modern Healthcare reports (Barr, Modern Healthcare, 1/29).Â
About the Plan
Under Obama's plan, many of the estimated 11 million undocumented immigrants in the U.S. would be offered a "provisional" or "probationary" status, allowing them to stay in the U.S. legally and potentially earn citizenship over time (Baker/Viebeck, "Healthwatch,"Â The Hill, 1/29).
However, those individuals would not be eligible for the ACA's benefits and would be exempt from the law's individual mandate while seeking full citizen status (Modern Healthcare, 1/29).Â
The ACA states that non-citizens are eligible for benefits under the law if they are "aliens who are lawfully present" in the U.S., according to "Healthwatch." According to an analysis by the Congressional Research Service in 2011, that language means that legal permanent residents, asylum recipients and refugees, and non-immigrants -- such as temporary workers and representatives of foreign governments -- are considered "lawfully present" (Baker/Viebeck, "Healthwatch,"Â The Hill, 1/29).Â
According to theÂ Washington Post's "Wonkblog," such immigrants are subject to the ACA's individual mandate and those whose annual incomes are below 400% of the federal poverty level -- or $44,680 for an individual -- would qualify for insurance subsidies to purchase coverage through an exchange. They also qualify for Medicaid coverage after five years of legal residence.
However, the ACA stipulates that undocumented immigrants are prohibited from receiving federal subsidies to help purchase health coverage and are exempt from the individual mandate, although they are covered under the ACA's provision banning insurers from denying coverage to individuals with pre-existing conditions (Kliff, "Wonkblog,"Â Washington Post, 1/29).Â
Obama's plan comes one day after a group of bipartisan senators introduced a similar plan, which also would allow undocumented immigrants to earn a probationary legal status but would block them from receiving benefits through the ACA's insurance exchanges or its Medicaid expansion (Viebeck, "Healthwatch,"Â The Hill, 1/29).
Health Policy Experts Say Granting Benefits to Immigrants With Provisional Legal Status Could Lower Costs
Although provisional legal residents are ineligible for the ACA's benefits under Obama's proposal, some health policy experts say including such individuals could help reduce costs, according toÂ Modern Healthcare.Â
Sonal Ambegaokar, health policy attorney for the National Immigration Law Center, noted that young and healthy immigrants with a provisional legal status likely will be sought out by health insurers looking to keep costs down. She added, "If we continue to exclude [provisional legal residents], we're sending the message to [legal U.S. residents] that they don't need to get covered either."
Georges Benjamin, executive director of the American Public Health Association, also said allowing provisional legal immigrants to receive benefits under the ACA could be beneficial from a public health and economic viewpoint. "In those states where there are a high number of immigrants who are working, I would think you'd want to cover them," he said (Modern Healthcare, 1/29).Â
The Congressional Budget Office estimates that about seven to eight million undocumented immigrants will remain uninsured after the ACA takes full effect. However, if immigration reform were to reduce or eliminate the population of undocumented immigrants, new opportunities to gain coverage would be available to such individuals.
The Congressional Research Service has estimated that about 80% of non-citizens, or 17.5 million individuals, would qualify for some benefits under the ACA because of their income level ("Wonkblog,"Â Washington Post, 1/29).
Rubio Says Plan To Extend Benefits to Provisional Immigrants Is Deal Breaker
Sen. Marco Rubio (R-Fla.) on Tuesday suggested that he would withdraw support from any immigration reform deal that extends federal benefits to provisionally legal U.S. residents, "Healthwatch" reports.
In an interview on Rush Limbaugh's radio show, Rubio said that extending health benefits through an immigration reform plan would "[blow] a hole in our budget" and makes such a plan "un-doable." Rubio -- one of the eight senators who proposed a bipartisan plan for immigration reform on Monday -- noted, "Obamacare is the only federal benefit where you qualify for it not because you have a green card but because you're lawfully present." He added, "That issue needs to be resolved" (Viebeck, "Healthwatch,"Â The Hill, 1/29).ÂThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.