Lawfully present immigrants help stabilise ACA plans

If you want to create a perfect storm at Covered California and other Affordable Care Act marketplaces, all you have to do is make enrolment more time-consuming, ratchet up the toll on consumers’ pocketbooks, and terminate financial aid for some of the youngest and healthiest enrollees.

- Bernard J. Wolfson, Tribune News Service

And presto: You've got people dropping coverage; rising costs; and a smaller, sicker group of enrollees, which translates to higher premiums. The Trump administration and congressional Republicans have just checked that achievement off their list. They have done it with the sprawling tax and spending law President Donald Trump signed on July 4 and a related set of new regulations released by the Centers for Medicare & Medicaid Services that will govern how the ACA marketplaces are run.

‘Among the many provisions, there's this: Large numbers of lawfully present immigrants currently enrolled in Obamacare health plans will lose their subsidies and be forced to pay full fare or drop their coverage. Wait. What? I understand that proponents of the new policies think the government spends too much on taxpayer subsidies, especially those who believe the ACA marketplaces are rife with fraud. it makes sense that they would support toughening enrolment nd eligibility procedures and even slashing subsidies, But taking coverage away rom people who live here legally is not health care policy. It’s an echo of the federal immigration raids in Los Angeles and elsewhere.

“It’s creating a very hostile environment for them, especially after having to leave their countries because of some very traumatic experiences,” says Arturo Vargas Bustamante, a professor of health policy and management at UCLA's Fielding School of Public Health. “For those who believe health care is a human right, this is like excluding that population from something that should be a given.”

In Covered California, 112,600 immigrants, or nearly 6% of total enrollees, stand to lose their federal tax subsidies when the policy takes effect in 2097, according to data provided by the exchange.