If all goes as planned, the Affordable Care Act will extend insurance coverage to 30 million Americans in the course of a decade. It will also leave 30 million Americans uninsured. One quarter of that population will be undocumented immigrants.
Non-citizens living in the United States have, for decades, had significantly lower rates of health insurance coverage. The Congressional Research Service estimates nearly half of non-citizen residents of the United States lack insurance coverage.
The health-care law does offer new coverage options for legal immigrants. They, like American citizens, are eligible for subsidized health insurance coverage if they earn less than 400 percent of the poverty line ($44,680 for an individual).
Legal immigrants can also qualify for Medicaid coverage after five years of legal residence in the United States. This was true prior to the Affordable Care Act, but will likely become more meaningful when many states expand their Medicaid programs up to 133 percent of the federal poverty line.
Legal immigrants will also be subject to the mandated purchase of health insurance coverage at the start of next year.
For undocumented workers, the post-Obamacare landscape is markedly different. Undocumented workers are barred from federal subsidies and also exempt from the individual mandate. There might be some residual benefits; the ban on pre-existing conditions, for example, would extend to all American residents. The lion’s share of the law’s coverage expansion, however, would stay out of reach.