The Corner

Immigration Reform Threatens to Add 7 Million People to Obamacare

One effect of implementing the type of immigration reform proposed yesterday by the bipartisan gang of eight senators — or, for that matter, the type the president is expected to propose this afternoon in Las Vegas — will be the massive expansion of government-subsidized health care. 

According to the Washington Post’s Wonkblog, which cites data from the Congressional Research Service, comprehensive immigration reform will come at an enormous cost to our health-care system. The CRS estimates that, after implementation of President Obama’s Affordable Care Act, between 7 and 8 million illegal immigrants will remain uninsured. Immigration reform that includes a pathway to legal residency would, obviously, change that. The chart below breaks down non-citizens by their income levels. Amnestied immigrants who earn below 400 percent of the federal poverty level would be eligible for some of Obamacare’s insurance expansion, and most non-citizens fall below that threshold: 

Though the chart accounts for both legal and illegal non-citizens, it nonetheless provides some indication of the income levels among illegal immigrants, which determine the benefits they are eligible for under the Affordable Care Act (and, further, it seems unlikely illegal immigrants’ incomes are on average substantially higher than legal ones’). Wonkblog explains what benefits would apply to each group: 

The yellow chunk of the pie . . . are people who would qualify for the Medicaid expansion, although would be subject to a five-year waiting period (during that time, however, they would have the option to buy insurance using federal subsidies).

The blue slice . . . would qualify for federal subsidies to purchase private insurance coverage. The last part of the population, represented in red, would not qualify for assistance – not due to their immigration status, but because of their higher income. They would still, however, have access to their state health insurance exchange. Right now, undocumented immigrants are specifically barred from buying coverage there (as part of the purchasing process, Homeland Security will verify citizenship status).

Stretching the health law’s insurance expansion would, unsurprisingly, come at a price: Covering more people means spending more money. Medicaid spent an average of $7,434 per patient in 2011. 

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