Obamacare is in trouble. It seems that, every month, health care providers drop from the marketplace created by President Obama after a long and bitter fight with Congress that still resonates in the current campaign trail.
Aetna is the latest large health care company to pull back from the Affordable Care Act (ACA), also known as Obamacare. Aetna cut their presence from 15 states to just four, citing unsustainable losses as the reason for exiting most of the health care exchanges. United Healthcare, the largest health insurance provider, announced its withdrawal earlier this year.
The main problem with Obamacare is that many people are not buying the health plans because they consider them too costly. The predicted number of young and healthy beneficiaries are not enrolling. Instead, older and sicklier people are buying coverage, which raises the price of insurance for the general population.
Is there anything that can be done to save Obamacare? One politically daring option: Include immigrants in the ACA.
Immigrant advocates were disappointed when, at the announcement of Deferred Action for Childhood Arrivals, there was an immediate clarification that DACA recipients were excluded from enrolling in ACA.
There are 24 million people in the U.S. who don’t have health insurance, according to the Commonwealth Fund, a private, nonpartisan foundation. Forty percent of the uninsured are Hispanic, and millions are excluded from the health care exchanges because they are not U.S. citizens.
Undocumented immigrants and DACA recipients can buy employer-sponsored health plans. But many employers are small business owners with fewer than 50 employees, which are excluded from the mandate to cover employee health insurance. The reality is that a large percentage of Hispanics, documented or not, work for small businesses.
From an insurance standards perspective, it would be wise to allow immigrants to enroll: It is a large, young demographic that tends to be healthier and use less expensive services.
The U.S. government may include undocumented individuals by eliminating restrictions in the law or through much-awaited immigration reform. But the political road is considered risky.
ACA is an important idea with questionable execution that could be improved and saved for the future if the right changes are made. Immigrant inclusion may be the change that saves the health coverage of millions of U.S. citizens.