Instant Life Insurance Blog News: 23M To Remain Uninsured After Health Care Reform

The federal health care overhaul is expected to provide 32 million uninsured Americans with coverage by the time it’s fully in place in 2019.

But even under the Obama-sponsored reforms, about 23 million people will remain uninsured for reasons including exemptions from the requirement to buy health insurance, the Congressional Budget Office estimates.

It projects that about one-third of those people — 8 million in all — will be undocumented immigrants.

The health reform legislation specifically prohibits illegal immigrants from buying health insurance, even with their own money, from the federal exchanges that are to be created by 2014.

The law also exempts people with religious objections, those who are imprisoned and members of American Indian tribes from the mandate to buy health insurance.

Also exempted would be those for whom even the cheapest insurance would cost more than 8 percent of their income, though it’s likely that some will buy it anyway, says Jennifer Tolbert, associate director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured.

The remainder of the uninsured would be people who are eligible for Medicaid but don’t enroll and those who would rather pay a fine than buy insurance.

The exclusion of undocumented immigrants means many will continue to seek medical care in hospital emergency rooms, where they can’t be turned away, or from low-cost community health centers.

Chuck Weis, chief financial officer of Mount Sinai Hospital, estimates that “roughly one-third of our uncompensated care would probably remain under health care reform, primarily due to the issue of undocumented immigrants.”

Last year, the hospital on Chicago’s West Side provided $33.6 million of uncompensated care, and emergency visits have soared since 2007. Under health reform, special payments to “disproportionate share” hospitals like Mount Sinai that serve large numbers of poor and uninsured patients would be slashed.

But the expansion of Medicaid as part of health reform could offset those losses, says Roberta Rakove, Mount Sinai’s senior vice president of government affairs.

“You would hope that as you see more people covered by Medicaid, you would see fewer ER visits,” Rakove says.

Dan Hawkins, of the National Association of Community Health Centers, says the expansion of insurance coverage ultimately will leave those who remain uninsured with fewer options for care, as doctors take on more patients.

Community health centers, though, would benefit from $11 billion in new federal funding that should allow these centers to double to 40 million the number of patients they serve by 2015. Of those, an estimated 10 million will be uninsured, Hawkins says.

Comment at suntimes.com.

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