Is Medical Help for Illegal Immigrants Covered Under Obamacare?

How the Affordable Care Act Treats Undocumented Immigrants

Nurse with elderly male patient

Jose Luis Pelaez / Iconica / Getty Images

Medical help for illegal immigrants is prohibited under Obamacare, the Patient Protection and Affordable Care Act signed by President Barack Obama in 2010. The law is designed to make health insurance more affordable for low-income Americans but does not grant undocumented, or illegal, immigrants access to taxpayer-funded subsidies or credits to buy health insurance through exchanges.

The relevant section of the law, also known as Obamacare, is Section 1312 (f)(3), which reads:

"Access limited to lawful residents. If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.

Medical help for illegal immigrants is still available in many cities across the United States, however. A 2016 survey of counties that have the largest populations of illegal immigrants found most had facilities that offer illegal immigrants "doctor visits, shots, prescription drugs, lab tests, and surgeries." The services cost U.S. taxpayers more than $1 billion a year. The survey was conducted by The Wall Street Journal.

"The services usually are inexpensive or free to participants, who must prove they live in the county but are told their immigration status doesn’t matter," the newspaper reported.

Individual Mandate and Undocumented Immigrants

Undocumented immigrants living in the United States are the largest segment of the population without health insurance. It has been estimated that as much as half of the illegal immigrant population in the United States doesn't have health insurance. The Congressional Budget Office has estimated illegal immigrants make up one-quarter of the 30 million uninsured people in the country.

Undocumented immigrants are not subject to the health care reform law’s individual mandate, the controversial clause upheld by the U.S. Supreme Court in June 2012 requiring most Americans to purchase health insurance.

Because illegal immigrants are not subject to the individual mandate, they are not penalized for being uninsured. According to the Congressional Research Service: "Unauthorized (illegal) immigrants are expressly exempted from the mandate to have health insurance and, as a result, cannot be penalized for noncompliance."

Illegal immigrants can still get emergency medical care under federal law.

Controversial Claims

The question of whether Obama’s health care reform legislation provides coverage for illegal immigrants has been the subject of some debate over the years, largely because of their ability to still get treatment in emergency rooms and other facilities at the local level.

U.S. Rep. Steve King, a Republican from Iowa, claimed in a 2009 written statement that Obama's health care reform law would provide coverage to 5.6 million illegal aliens because the government would not verify the citizenship or immigration status of those receiving taxpayer-funded health benefits.

"Taxpaying families already weighed down by bailouts and massive spending bills, cannot afford to pay for health insurance for millions of illegal aliens. Hard and smart working Iowans should not be forced to pay for illegal aliens to obtain health benefits under any health care reform plan," King said.

Obama Refutes Claims

Obama sought to clear up confusion and address many misleading statements about his proposals in a 2009 speech before a rare and notable joint session of Congress. "Now, there are also those who claim that our reform efforts would insure illegal immigrants. This, too, is false," Obama said. "The reforms I am proposing would not apply to those who are here illegally."

At that moment in Obama's speech, Republican U.S. Rep. Joe Wilson of South Carolina brazenly shouted "You lie!" at the president. Wilson later called the White House and apologized for his outburst, calling it "inappropriate and regrettable."

Continued Criticism

Republican U.S. Sens. Tom Coburn and John Barrasso, opponents of the health care reform law, criticized the Obama administration’s handling of illegal immigrants in a report titled "Bad Medicine." They said the cost of allowing illegal immigrants to get health care in emergency rooms will cost taxpayers untold millions.

"Starting in 2014, Americans will be subject to the individual mandate penalty of $695 annually if they do not purchase federally-dictated health insurance," the lawmakers wrote. "However, under the new federal law, illegal immigrants will not be forced to purchase health insurance, though they will still be able to receive health care — regardless of their ability to pay — in a hospital's emergency department."

Undocumented immigrants already have access to emergency-room treatment.

"So illegal immigrants get health care without paying for it, but citizens face the choice of either buying expensive health insurance or paying a tax," Coburn and Barrasso wrote. "The cost of illegal immigrants‘ health care in the emergency department of hospitals will be shifted to Americans with insurance."

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Murse, Tom. "Is Medical Help for Illegal Immigrants Covered Under Obamacare?" ThoughtCo, Aug. 26, 2020, Murse, Tom. (2020, August 26). Is Medical Help for Illegal Immigrants Covered Under Obamacare? Retrieved from Murse, Tom. "Is Medical Help for Illegal Immigrants Covered Under Obamacare?" ThoughtCo. (accessed December 3, 2022).