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To the Editor: Dr Ayanian and colleagues¹ state that a significant number of uninsured adults in the United States forgo needed medical attention. However, many of these uninsured persons are not US citizens. A recent Kaiser Family Foundation report states that immigrants make up about 10% of the population, yet account for 20% to 25% of the uninsured population.² A significant fraction of these immigrants are in the United States illegally. Legal immigrants are ineligible for Medicare for 5 years. Each legal immigrant must have a sponsor who pledges to provide support for 5 years so that the immigrant does not become a public charge. Even then, Medicaid still provides support for emergency situations.

The insurance problems will only increase as more people immigrate legally and illegally to the United States. A significant part of the problem of adults not being insured in this country can be traced directly to . . . [Full Text of this Article]

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