By Jude Joffe-Block, KJZZ News, for Fronteras
PHOENIX – About 48 million Americans lack medical insurance. That’s poised to change next year when expanded Medicaid and federal tax credits for insurance become available under the Affordable Care Act. But there’s a huge group left out: the 11 million immigrants in the country illegally are currently barred from both programs.
Nineteen-year old Maria Diaz was born in Mexico and grew up in Arizona without papers. Her young life so far hasn’t involved many encounters with doctors.
MARIA DIAZ: “We didn’t have like extra money to just throw out if I broke something. So as a child I actually took precautions of trying not to hurt myself or get sick or break bones.”
Now Diaz is working, she recently qualified for a work permit under the Obama administration’ deferred action program for young immigrants. But her new minimum wage job at a gym doesn’t come with benefits.
DIAZ: “At this point in my life I still dont have health insurance or someone to go to if I dont feel good.”
Diaz’s immigration status means she isn’t eligible for Medicaid, and can’t buy insurance under the new health care exchanges that the Affordable Care Act will create next year. But could that change with immigration reform?
MARCO RUBIO: “If Obamacare is available to 11 million people, it blows a hole in our budget and makes this bill undoable.”
That was Florida Senator Marco Rubio earlier this year in an interview with Rush Limbaugh. Rubio has been central in negotiations over immigration reform.
RUBIO: “That’s one of the major issues we’re gonna have to confront.”
Adding these immigrants under the Affordable Care Act would cost billions, and would mean expanding a program that many Republicans already want to abolish. Most immigration reform proposals on the table offer those here illegally some kind of provisional legal status, that will require they wait many years, likely around ten to fifteen, to qualify for federal health benefits. But there are also huge costs to leaving immigrants uninsured.
SONAL AMBEGAOKAR: “Since all of us now are required to pay for insurance under the Affordable Care Act, it is better for us to have immigrants in the pool…”
Sonal Ambegaokar is with the National Immigration Law Center.
AMBEGAOKAR: “…Because if there are more people in the pool, especially those who are younger and healthier, which immigrants generally are, then our individual premium costs will go down.”
It’s worth mentioning that not every immigrant in the country illegally and awaiting immigration reform is uninsured. An estimated 40 percent actually have health insurance — most of them through their jobs, according to the Migration Policy Institute. The rest though, in the absence of federal benefits, will likely rely on safety net providers.
BETTY MATHIS: “This is the waiting room, as you can hear, I think you can hear some babies crying in the background.”
Betty Mathis runs a community health center in South Central Phoenix for low income patients.
MATHIS: “Our insured patients total 12 percent of our patient population, so that means 88 percent of our patients are uninsured.”
These kinds of clinics all over the country are bracing for increased demand next year as more low income people qualify for Medicaid and start using medical services. But they will also be one of the only options for the uninsured. Randy Capps with the Migration Policy Institute says these safety net providers might be overwhelmed. Especially in states with a high immigrant population.
RANDY CAPPS: “The currently unauthorized population–and that is the population that would legalize under immigration reform– is heavily concentrated in the Southwest….So those states are most at risk for pressure on their safety net health care systems.”
Arizona, Nevada, California and Texas — These are the states that have the highest share of uninsured, poor adults who wont get Medicaid because of immigration status, that’s according to estimates by the Robert Wood Johnson Foundation. Adding to the strain, hospitals, the ultimate safety net, will be receiving fewer federal dollars to treat uninsured patients, Capps says there is a potential fix.
CAPPS: “The last legalization law, way back in 1986 provided state grants to help cover health care costs for legalizing immigrants.”
And indeed, those state health care grants continue to be part of the ongoing debate over immigration reform this time around.
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