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Assessing Health Care Impacts of Reforms for Immigrants

With the national debate turning from health reform to immigration reform, health policy experts, immigrants and immigrant rights organizations are assessing the health care impacts of one sweeping reform already signed into law and the potential impacts of the next one.

In California, where the immigrant population is large and growing, the ramifications of both reform efforts are particularly significant. In some parts of California, immigrants are almost as numerous as those who are native born.  According to the 2000 census, foreign-born residents accounted for 40.9% of the population of Los Angeles. That number could be higher in the 2010 census.

The new health care reform law specifies that documented immigrants and naturalized citizens will have the same access to affordable health insurance as U.S.-born citizens in the new insurance exchanges. As will all citizens, immigrants have health insurance or pay a tax penalty if they fail to secure it. They can apply for tax credits to help pay for health insurance or they can apply for an exemption from the requirement if health insurance remains unaffordable.

Many lawfully present immigrants will remain ineligible or be required to wait years to enroll in Medi-Cal, California’s federally subsidized Medicaid program. While they can buy health insurance and apply for tax credits in insurance exchanges, this option may still be unaffordable for low-income immigrant families.  

Undocumented immigrants — children, as well as adults — are not recognized in any way in the health care reform law. Undocumented immigrants are not eligible for federal health care programs, nor are they eligible for coverage through insurance exchanges.  Undocumented immigrants cannot legally buy health insurance even with their own money.

We asked experts to consider two questions:

How will the new health care law affect immigrants in California? How might immigration reform affect health care for immigrants in California?

We got responses from:

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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