If the Supreme Court decides to uphold PPACA, roughly 26 million people will remain without health coverage. Of those, 25% will be illegal immigrants, according to Urban Institute estimates. PPACA reduces federal payments to hospitals that treat a disproportionate share of uninsured people, but the hospitals will still be required by law to provide emergency treatment to those who need it. Hospitals will start treating more patients who can pay, but the money dedicated to help pay for the uninsured will drop by $57 billion over a decade. Advocated for the immigrant community are concerned that hospitals will cut back on preventative or follow-up treatment for illegal immigrants.

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