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Welcoming Obamacare for Some, Fighting for Care for All

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Remember when opponents of President Obama's health care reform proposal derisively called it "Obamacare?" Since then, the Affordable Care Act (ACA) has survived legal challenges and political attacks, so the president's confidence in the program caused him to embrace the term.

Obamacare is taking our nation into a new era where mothers, fathers, workers, and children will have access to quality, affordable health care. Today is a historic day that marks the start of open enrollment in the health insurance Marketplace. The Marketplace, or exchange, will provide millions of uninsured Americans access to affordable health insurance, with coverage beginning Jan. 1, 2014.

Of course, a small segment of short-sighted lawmakers in Congress continue attempting to hold prudent decision-making hostage and have not given up trying to block what could be the most important health care law in almost a half century. In the end, all they achieved was irresponsibly shutting down the federal government. Thankfully for the American public seeking a health care safety net, their attempts to defund or delay Obamacare have failed.

The long-awaited program will be especially helpful to low- and middle-income working families and individuals, including immigrants and communities of color, who are disproportionately uninsured. Obamacare is supported by 61 percent of Latinos, according to a recent poll by Pew Research Center for the People and the Press.

The poll also showed that the lower the family income, the more likely individuals are to support Obamacare because it provides a critical safety net for all families. It forces insurance companies to spend more on actual care and less on administrative costs; prohibits plans that discriminate based on pre-existing conditions or deny coverage when the beneficiary gets sick. It also expands Medicaid in many states to more of the working poor, and gives tax credits to small employers who provide insurance coverage to their employees and to individuals who need help paying for insurance.

However, there is one critical gap in Obamacare. To build a healthy society and economy, lawmakers must allow everyone -- regardless of immigration status -- the opportunity to participate in the insurance exchanges, pay their fair share for health insurance, and keep themselves and their families healthy and productive.

Under Obamacare, not only are undocumented immigrants excluded from the subsidies that will help other Americans afford their health insurance, they are also denied access to private health insurance at full price in the Marketplace, and continue to be excluded from Medicare, nonemergency Medicaid, and the Children's Health Insurance Program (CHIP). However, parents who lack lawful status can apply for health insurance for their eligible family members, including citizen children or lawfully present family members.

This exclusion is costly from moral and fiscal perspectives. If all families are given access to preventive health care, costs will be reduced for everyone. This opinion is shared by health care providers and medical professionals across the U.S.

Dr. Paula Tran, a physician at San Francisco General Hospital in California, has written about how the lack of access to primary care and early medical intervention for her undocumented patients needlessly led to increased suffering. She told the story of a young patient from Thailand who had been coughing up blood for six months before seeking medical care.

Dr. Danielle Ofri, who practices at Bellevue Hospital in New York, wrote of a patient she'd been seeing for years who brought his mother to an appointment so that the doctor could examine a stony mass in her breast. She arrived too late for treatment and died of cancer soon after. The doctor realized during that visit that the patient was married with two young children. "His parents lived with him, as well as an aunt. But no one was getting any medical care because they were undocumented and worried about deportation," Ofri wrote.

These doctors and others agree that this critical gap must be fixed. And it should be fixed as part of immigration reform.

The Senate's bipartisan immigration bill would allow immigrants who qualify for "Registered Provisional Immigrant" status -- the first step on the road to citizenship -- to live and work here and would be required to pay the same taxes as other Americans. But they would have to wait at least 10 to 13 years to participate in Obamacare and other programs their tax dollars support.

So, as we celebrate the start of Obamacare, let's remember that each of us should have the opportunity to be healthy and to protect our families, so that we can all aim for our dreams, regardless of income or immigration status. We are committed to fighting for a future in which all Americans have access to affordable, quality health care and we can live and work in healthy communities.