Care 411


Obamacare Cuts to Hospital Aid, And Unintended Consequences

admin November 8, 2018

Under the premise that the new healthcare law will provide medical coverage for many of the nation’s uninsured and under-insured, a provision of the Affordable Care Act proposes to save costs by drastically cutting a $20 billion fund that for years has reimbursed and aided hospitals that treat a disproportionate share of the nation’s poor.  However, in order to gain coverage, even under Obamacare, patients must prove either U.S. citizenship or legal resident status.  This will leave many hospital emergency rooms in poor urban and rural areas with a large patient pool of illegal immigrants to care for, with reduced federal aid and reimbursement.

As explained in a recent article in the New York Times, amidst the contentious negotiations that drove the final drafts of the bill, the matter of care for illegal immigrants was considered too hot a topic to bargain on.  With immigration being such a polarizing issue in the United States, other bills and laws, including the Violence Against Women Act,  have been greatly jeopardized due to their inclusion of provisions to protect or care for illegal immigrants.  As difficult as the fight was to get the Affordable Care Act drafted and passed, it was argued that including provisions for illegal immigrants was too politically risky.

Some argue that such legal exclusion may actually help reduce the influx of illegal immigrants into the United States, and even encourage those already living here to return to their home country.  While Mark Krikorian, the executive director of the Center for Immigration Studies in Washington, said he wishes to see no one suffer and die needlessly from lack of healthcare, he also believes that illegal immigration is causing serious problems in the nation that will only be resolved by the reduction of the immigrant population, either by their return to their home countries, or by reducing the influx rate of new immigrants.

However, it is not only illegal immigrants who are strained by this provision.  Hospital emergency rooms are legally prohibited from turning away anyone who needs care, regardless of their insurance status, financial means, or immigration status.  In poor rural and urban areas, this leaves many hospitals treating a disproportionately high number of uninsured and under-insured.  A substantial percentage of these patients are illegal immigrants.  With the upcoming cuts implemented by the Affordable Care Act, these hospitals will still have to treat a large number of patients who won’t have coverage due to their illegal immigration status.  This financial strain will decrease the quality of care for all patients, strain the working conditions of the medical staff, and even threaten the solvency of these institutions.

With the Affordable Care Act’s passing as tenuous as it was, it is politically understandable that those fighting for it would want to leave as many divisive issues as possible off the table.  However, in this case, one must ask if the cost to hospitals in this provision is worth it.  One may speculate that when faced with a lack of access to insurance, illegal immigrants may decide to return to their own countries, and prospective immigrants may decide not to come at all, if not legally.  However, in human nature, there are no guarantees.  In this situation, the only realistic surety seems to be the continued influx of low-income, uninsured, or under-insured patients into these hospitals, both citizens and immigrants, with the hospitals’ decreased means in financial capital to care for them.  Is it worth it?

Do you agree that leaving provisions for illegal immigrants out of health care reform is a worthwhile and effective way to reduce the problems of illegal immigration?  Or do you think this measure punishes the wrong people?  Would you recommend a fix for this measure?  Or do you see it as problematic at all?  Does this affect your support or aversion to the Affordable Care Act in any way?  Please share your input in our comments.

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