Health care law ignores illegal immigrants; hospitals may get stuck with the bill

Hospital leaders told The New York Times they're wary of terms in the health care reform law that will eventually halve the amount of money they receive for caring for uninsured people without addressing the estimated 11 million illegal immigrants in the country, most of them lacking insurance.

Emergency rooms are required to take in all patients, insured or uninsured, under a federal law signed by President Ronald Reagan. The government used a pot of about $20 billion to reimburse hospitals each year for this care. But that pot is going to be cut in half by 2019, under the reasoning that the health care law will dramatically cut the number of people who don't have insurance, thus saving hospitals money. The calculation leaves out one key group of uninsured people: illegal immigrants, who will not be required to buy health insurance or be eligible for Medicaid, or be allowed to purchase insurance on state-run exchanges under the law.

Earlier proposals that addressed illegal immigrants were scrapped during the health care debate after they drew controversy.

In New York City public hospitals, an estimated 40 percent of all uninsured patients treated are undocumented, and other hospital systems have an even larger share. Experts estimate that about 6 million of the nation's uninsured are illegal immigrants.