The big question in healthcare this week is what impact, if any, President Obama’s immigration proposal will have on the ACA. Will those immigrants benefit from the ACA if immigration reform is passed? And will they receive the same health coverage and benefits as the American people? It depends.

Currently, under the ACA, naturalized citizens and legal immigrants will have access to free or subsidized health coverage if have been living in the United States for more than five years. Those legal immigrants who have been residing in the country for five years or less with incomes below 400 percent of Federal Poverty Level also receive access to subsidized coverage.

However, unauthorized immigrants are not eligible to receive Medicaid, Children’s Health Insurance Program coverage, or subsidies. Also, they are not allowed to even purchase private coverage health insurance exchanges. Therefore, unauthorized immigrants are at risk of having no health coverage and must find other forms of outpatient care that will provide for their health needs.

Because unauthorized immigrants are not allowed to purchase or obtain health coverage, they will be “exempt” from paying a penalty under the ACA.

According to a study from January 2011, the U.S. Department of Homeland Security estimates that there are approximately 11.5 million unauthorized immigrants currently living in the United States. The study also illustrates that the unauthorized immigrant population has been steadily increasing over the years. In 1980, there were an estimated 2 to 4 million immigrants in the United States; by 2000, that number had increased to 8.5 million.

Providing health coverage to newly eligible immigrants on top of the 46.6 million (2008) uninsured Americans will be exhaustive and intensive work. Not to mention, it will be costly due to an increase in eligible healthcare enrollees. However, for those immigrants who have been living without health insurance, the ACA will provide much needed relief.

Before the ACA is implemented in 2014, there are key issues that may arise with the immigration reform. The director of healthcare policy at the American Action Forum, Sarah Hale, stated in The Hill’s healthcare blog that it was too early to predict if this immigration policy would have any effect in raising the cost of healthcare. However, she does comment, “…if there are a huge swath of people who are newly eligible for an insurance subsidy or for Medicaid, then naturally that is going to impact the budget number.”