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Have a Health Care Reform Headache?

Have a Health Care Reform Headache?


August 27, 2009

Q: How many of the uninsured are undocumented immigrants?

As many as 7 million. An additional 3 million are legal immigrants, according to the U.S. Census.

Q: Under the bills backed by congressional Democrats, will illegal immigrants get free health care benefits?

No. Provisions in the House and Senate bills explicitly prohibit people who are “not lawfully present in the United States” from getting federal aid to help them buy health insurance in the new insurance exchanges.

Congressional Democrats have resisted Republican efforts to put even tougher documentation requirements on those applying for aid, however, arguing that that could discourage many poor people from signing up for health insurance.

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No matter what happens with the legislation, undocumented immigrants will almost certainly still be able to get care in emergency rooms, a major burden in some parts of the country.

Q: What are “employer mandates” and “individual mandates”?

These mandates are the heart of health care reform legislation. The employer mandate would require employers to provide health insurance coverage for their employees or pay an annual fee. Employers would also be required to contribute most of the premium cost for this coverage. Exceptions are made for small businesses based on the size of their payrolls.

The individual mandate requires individuals to have health insurance – either through their employers or purchased individually – or pay a tax penalty every year.

Lower-income individuals and families would be eligible for subsidies or tax credits to help them acquire health insurance.

Q: Will all of the people without insurance be covered?

Not all of them. Although all the major proposals would require everyone to get health insurance, millions of people still are not expected to sign up.

Under the House bill, the percentage of people with coverage (excluding undocumented immigrants) is expected to go from about 83 percent in 2010 to 97 percent in 2019, according to the nonpartisan Congressional Budget Office The Senate health committee bill would boost the coverage rate to 90 percent.

Tricky subjects: abortion and rationing…

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