Immigrant Health Care in The United States - Recent Legislation

Recent Legislation

On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama. This legislation, joined with the Health Care and Education Reconciliation Act of 2010, seeks to expand coverage and improve access to the health care system while simultaneously managing its costs. Among PPACA’s provisions are: the requirement that all U.S. citizens and legal residents possess health insurance; the creation of refundable tax credits for households between 100% and 400% of the federal poverty line; the expansion of Medicaid eligibility; the provision of free preventative services; the extension of dependent coverage to age 26; new funding to support community health centers; and more. Although not all of the act’s reforms are slated for immediate implementation, the changes, needless to say, have many implications for the immigrant and noncitizen population.

PPACA’s creation of subsidies to make insurance more affordable notably benefits legal immigrants, given that they comprise a large number of the uninsured population. In contrast, undocumented immigrants are denied these subsidies and further prohibited from participating in federal or state health insurance exchanges, though their lawfully present children will be eligible. Regardless of citizenship status, however, PPACA’s funding for the development of new community health centers has the potential to help both legal and undocumented immigrants who lack coverage.

Views on the act’s contributions to the immigrant and noncitizen population vary. Some argue that the reform has immense benefits by addressing coverage gaps and extending more benefits to naturalized citizens. Others argue that substantial disparities still exist, with an estimated 3.7 million adults remaining uninsured due to their undocumented status. Furthermore, because the act does not address the five-year waiting period placed by PRWORA, more recent low-income legal immigrants may not seek insurance “for want of resources to pay their share of the costs.”