While the Patient Protection and Affordable Care Act has led to an unprecedented increase in health care coverage, particularly in the nation's poorest communities, many immigrants are still facing serious challenges in getting coverage.
More than 400,000 people have seen the insurance plans they purchased through the PPACA insurance exchange cancelled in 2015 due to questions over their immigration status. That is a dramatic increase over the 109,000 such cancellations last year.
Immigrant advocates say the bulk of those getting kicked off plans are legal residents who are entitled to apply for the subsidized insurance plans, and that the denials are a result of a complicated and inflexible bureaucracy.
The cancellations are largely a result of a new 95-day timeline imposed by the Obama administration for resolving immigration issues related to the health care law. In 2014, the law's first full year of implementation, there was no such timeline established.
Angel Padilla, a health care analyst for the National Immigrant Law Center, told the Associated Press that it makes little sense that an undocumented resident would be applying for a government program that might risk outing them as unauthorized immigrants.
“Somebody who is trying to submit documents over and over … is someone who believes they have an eligible immigration status,” she said.
Padilla also said that the timeline is not necessarily the problem, but rather the lack of communication from the federal government to immigrant applicants about what documents they need to provide and when they are due.
The Obama administration is in an uncomfortable political position in attempting to resolve the issue.
On one hand, the goal of the PPACA is to enroll as many in insurance plans as possible, and getting coverage for Latinos, many of whom are immigrants, is an important part of the equation. The uninsured rate among Latinos has dropped from 41 percent to 28 percent, a major success for the law. And at a time when Democrats are describing Republicans as hostile to immigrants in general and Latinos in particular, the Obama administration does not want to appear to be neglecting the nation's largest ethnic community in its signature domestic policy.
But on the other hand, the Obama administration is also trying to defend against attacks that the PPACA is providing insurance to undocumented immigrants. That fear may partially explain the cautious steps taken in assessing immigration status.
Last year, an investigation by the Government Accountability Office succeeded in enrolling fictional applicants in insurance plans through HealthCare.gov. But the probe also faulted the health care website for failing to notify applicants about whether the documents they had submitted were acceptable.
“We did not always know the current status of our applications or specific documents required in support of them,” said the GAO report.
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