More than 5 million undocumented immigrants have applied for emergency room visits in the United States since 2000, and the number is expected to grow, a report released Wednesday by the nonpartisan Congressional Budget Office predicts.
That’s nearly twice the number of undocumented immigrants admitted to the U.S. during the same period, and almost three times the total number of Medicaid-eligible uninsured residents nationwide, the CBO reported.
In a separate report, the group also noted that about one in five Medicaid-covered adults have been uninsured for five years or more.
But the CBO said that, while the majority of those without coverage are not eligible for subsidies, they are not ineligible for tax credits, and they are eligible for federal subsidies.
The number of uninsured adults without coverage will rise from about 4.7 million in 2020 to 6.9 million by 2026, CBO projects.
About 6.7 percent of the undocumented population, or about 16 million, are uninsured, the nonpartisan group said.
About 13.6 percent of adults with incomes under $25,000 are uninsured.
The CBO said the Medicaid expansion, which expanded coverage to nearly 3 million Americans and covered about 12 million people in 2020, will cost the government about $1.5 trillion in 2019-20 and 2024-26.
Medicaid has grown in popularity, especially among poor and middle-income Americans, and President Donald Trump and his administration have repeatedly said that the expansion will benefit the country’s poor.
Trump said earlier this month that he would repeal the law if he was elected, and he is seeking to repeal it through legislation that could take effect in February.
The report’s authors, David Card and Thomas Homan, said the growth in the number uninsured and those with incomes below 100 percent of poverty will increase the federal deficit by $1 trillion.
That would be the first time in nearly a century that the federal government has seen a budget shortfall when the debt is more than 90 percent of gross domestic product.
Card said the report is “very sobering” because the number will likely grow, and it also underscores the need for lawmakers to fix the program and get it fixed.
The nonpartisan CBO said Medicaid is more popular with poor people than with wealthy ones.
More than two-thirds of the uninsured have incomes below 400 percent of median income, while nearly one-third have incomes of less than 200 percent.
Card and Homan noted that the Affordable Care Act expanded Medicaid eligibility to the most poor Americans, with about 2 million eligible.
But, Card said, that’s a drop in the bucket compared with the nearly 10 million uninsured in the state of New York, which added nearly 5 million new Medicaid enrollees in 2018.
The authors also said that although the uninsured rate is at the lowest level since the Medicaid expansions began in 2020 and remains below 25 percent, it will likely continue to increase.
The Medicaid expansion has helped the uninsured to obtain health insurance coverage in some states, but they are also at risk of being denied coverage if they have health problems or have other health issues that require medical care.
About half of all uninsured Americans have health issues, according to the report, and some states have had trouble filling the gaps.
Card called the Medicaid coverage gap a “national health emergency” because it affects a large portion of the country.
In New York and New Jersey, for example, about 30 percent of eligible adults lack coverage and the state has seen an increase in the rate of Medicaid denial for uninsured adults, Homan said.
“We need to take a much broader look at how we are doing things and how we improve access to care,” Homan told reporters Wednesday.
Card pointed to a separate study from the Kaiser Family Foundation that showed the state that had the largest increase in Medicaid denial was Vermont.
“This is really a wake-up call to states that are struggling to fill these gaps that this is an urgent and pressing problem,” Card said.
The state had a Medicaid denial rate of 29.1 percent, which the report said is “well above the national average” and was “significantly higher” than other states that have struggled with the problem.
Homan and Card said that some states are trying to fill the gaps with vouchers, which allow people to pay their own health care costs through a financial transaction system.
They said the system needs to be better integrated into health insurance markets, and states should be required to spend money to enroll people into the system.
The new report also said about 5 million Americans, or one in eight adults, are currently enrolled in Medicaid, which covers low-income adults, elderly people and low-skill workers.
The federal government also has about 1.2 million beneficiaries of the program, the report noted.
But in the meantime, the federal program has faced a number of challenges, with enrollment and payments under the ACA falling in recent years.