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With enrollment for health care insurance set to open in a few days, public opinion polls show there is still much confusion about how Obamacare will work. Congressional opponents of the Affordable Care Act (ACA) are using the current state of bewilderment to try to stop the health care program before it has a chance to serve people who desperately need it. They threaten to hold the federal government and the health of Americans hostage.

 

But buried in recent polling is this clear conclusion: just over a majority of voters do not like Obamacare -- largely because they don’t understand it -- but they want it fixed, not killed. Of the 53% who oppose the health care law in a project sponsored by the Pew Research Center and USA Today, most of those voters said they want elected officials “to make it work as well as possible,” instead of making it fail.

The National Immigration Law Center could not agree more. Obamacare needs fixing, but in the meantime, let’s make it work. The program is too vital to millions of people and must not be sacrificed at the altar of political gamesmanship.

 

Access to affordable health coverage and care is essential to a person’s ability to live and work and be a contributing member to society. It is fundamental to being able to provide for and take care of one’s family. We are all better off when more people are paying their fair share for health coverage and have the opportunity to be healthy and productive.

 

The goal of the health reform law is to provide access to affordable health coverage to those who do not have it, so there should be no changes for most Americans who already get health insurance through their employers, Medicare, Medicaid or the U.S. Department of Veterans Affairs.

 

Obamacare will dramatically improve access to coverage for the millions who are currently uninsured. This includes coverage for the foreign-born population in the U.S. who are lawfully present -- including naturalized citizens -- since they are 2.5 times more likely than native-born citizens to have no health insurance.

 

Under the ACA, citizens and immigrants in the U.S. lawfully will have access to the insurance marketplaces that will open October 1 and be able to apply for income-based subsidies to help buy coverage. This is an important development for millions of Americans who remained uninsured because they cannot afford it.

 

However, Obamacare falls short when it comes to undocumented immigrants and young people who have a temporary reprieve from deportation  under the Deferred Action for Childhood Arrivals (DACA) program.

 

Undocumented immigrants are specifically banned from buying insurance coverage through the exchanges, even if they can pay for it out-of-pocket, and both undocumented immigrants and DACA beneficiaries are ineligible for Obamacare subsidies. They also are not allowed to get coverage from public programs like non-emergency Medicaid and the Children’s Health Insurance Program (CHIP).

 

If they can afford it, undocumented immigrants can buy private insurance outside of the marketplace and DACA beneficiaries can buy both inside and outside the marketplace at full price. Both of these groups of immigrants can still get health insurance through their employer or that of a family member.  All those who remain uninsured will still be able to get emergency care at hospitals and go to community health centers. Finally, many states have other inclusive programs to help uninsured residents get health care which may benefit immigrants as well.

 

Many undocumented parents may fear that applying for coverage for their children who are citizens or are lawfully present in the U.S. will result in adverse immigration consequences. However, it is important that families and advocates know that when they apply on behalf of eligible family members, parents will not be required to provide information about their own immigration status or to provide a Social Security number if they do not have one.

 

Until this wide gap in Obamacare is closed and all Americans, including the 11 million aspiring citizens currently without status, are allowed to buy coverage on the exchanges, millions of Americans will remain uninsured. We must continue to improve access to affordable health care so that the entire nation benefits from having healthy communities.


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