Kokomo Tribune; Kokomo, Indiana

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September 13, 2013

Illegal immigrants not covered by ACA

Emergency room care will continue.

[Editor’s note: On Jan. 1, 2014, significant portions of the Affordable Care Act will be implemented. Every Friday until then, Kokomo Tribune will answer common questions about how the changes will affect health care consumers, including the personal responsibility mandate, the expansion of Medicaid, new health care exchanges and more.]

Q: Can someone in the U.S. illegally obtain Medicaid or a subsidy for private insurance? Will we be paying for non-residents’ access to health care?

A: Immigrants who are not authorized to be in the United States will not be able to receive health care coverage through the Affordable Care Act, but will continue to be treated in emergency rooms.

Currently both St. Joseph Hospital and Community Howard Regional Health provide emergency room care for uninsured people. The cases are often charity, with large portions of the cost written off as noncollectable.

Unauthorized immigrants will not be allowed to purchase insurance from the exchanges, receive subsidies for exchange coverage, or enroll in full-scope Medicaid, Kathy Young, CEO of St. Joseph Hospital said. They are also excluded from temporary high-risk pools.

“Unauthorized immigrants will remain eligible for emergency care under Medicaid if they would otherwise meet the eligibility criteria for Medicaid,” she said. “While some states may continue covering undocumented children with funds, they are not required to do so by the Affordable Care Act.”

Without access to insurance sold through the exchanges, unauthorized immigrants will likely remain uninsured at very high rates, Young said. Their access to primary care and other forms of outpatient care will depend on the ability and willingness of local safety net providers to provide care.

Financial planner Craig Dunn, a partner with Liberty Financial, said illegal immigrants are not subject to the mandatory coverage aspects of the ACA nor are they subject to any penalties for not having coverage.

“Illegal immigrants will still be able to go to the hospital emergency rooms for health care services,” he said. “To this taxpayer, it sounds as if illegal immigrants get free, taxpayer-funded health care without having any personal responsibility to acquire insurance.”

Dunn added this is no change in the current status.

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