Immigration 101: Will illegal immigrants now have health coverage?

President Obama is set to announce a sweeping plan Thursday night to shield some 5 million undocumented immigrants from deportation.

Up to 4 million such immigrants who have been in the United States at least five years will be eligible to apply for the program, and if accepted, will be allowed to work. Another 1 million will be eligible for protection through other means – including an expansion of the “Dreamer” program that defers deportation for people brought into the US illegally as children.

Mr. Obama’s action will have the force of law, unless or until it is overturned by Congress or in court.

One hot-button issue is whether these newly protected noncitizens will be eligible for health benefits, such as Medicaid and federal subsidies for insurance under the Affordable Care Act (ACA). The answer is no, according to multiple sources with knowledge of the Obama administration’s plan. Dreamers are also not eligible for federal health programs.

Supporters of Obama’s plan are disappointed by the administration’s decision to withhold health coverage, saying that hinders newly protected immigrants’ ability to participate fully in society.

“We would all benefit if more people had access to health care services,” Angel Padilla, a health policy analyst at the National Immigration Law Center, told The New York Times.

But to opponents of Obama’s move to defer deportations – which they call “executive amnesty” – adding health-care benefits would have only fueled their outrage.

Under the ACA, undocumented immigrants are not eligible for federal subsidies to buy insurance, and are not allowed to buy insurance via the state and federal exchanges. In September, 115,000 immigrants were kicked off their ACA-facilitated health plans after failing to prove their legal status.

But in fact, the federal government already subsidizes some health care for illegal immigrants. Under a system informally known as “emergency Medicaid,” hospitals are reimbursed when they provide emergency and maternity care for people who would otherwise be eligible for Medicaid if they were in the US legally.

The federal government paid out $1.3 billion for the program in 2011, with the states paying hundreds of millions more, The Washington Post reported last year.

About half the states have expanded Medicaid under the ACA, which means Obama’s health reform is also effectively helping some illegal immigrants.

There’s also a federal law, called the Emergency Medical Treatment and Active Labor Act, or EMTALA, which requires hospitals to provide emergency health care for anyone who arrives needing it, regardless of immigration status. For nonemergency care, undocumented immigrants can go to community health clinics.