Undocumented immigrants represent a growing percentage of the uninsured, a new study from researchers at the Urban Institute concludes. Between 1999 and 2007, the number of undocumented and uninsured immigrants grew from 8.5 million to 11.8 million and as a result, “the proportion of the uninsured in America who are undocumented immigrants increased from 1 in 8 (12.5 percent) to 1 in 7 (14.6 percent)”:

The Affordable Care Act will not provide subsidized coverage for the undocumented in the state-based exchanges, meaning that they will “eventually constitute a larger percentage of the uninsured population unless other policy actions are taken to provide for their coverage, or their immigration status is changed.”

In the meantime, the uninsured will continue to receive care in community health centers, emergency Medicaid services and through the nation’s doctors and hospitals — just as federal funding for uncompensated care decreases. But as Dr. Stephen Zuckerman, the author of the study, pointed out during a phone interview, “to the extent that a lot more people have coverage, revenues are increasing” and providers (particularly hospitals) “could have more opportunities to cross subsidize” the cost of uncompensated care with their new insured customers.

Rep. Steve King (R-IA) dismissed a key accomplishment in the Affordable Care Act – elimination of the Medicare donut hole – today, calling it “a minor part of this whole picture” and not “a significant piece of policy.”

King made the comments to ThinkProgress following a Republican press conference on Capitol Hill today. The Iowa congressman joined several Republican colleagues to renew their call for repealing the landmark health reform law “by the roots,” as King often says, including its provisions to close the Medicare Part D coverage gap, also known as the “donut hole.”

ThinkProgress asked King about what would happen to the millions of young people and seniors who are already enjoying the Affordable Care Act’s successes. King ridiculed the notion out of hand, saying, “I can’t imagine there being any seniors who have seen any benefits of Obamacare.” When we pointed out that millions would benefit from closing the donut hole, King was dismissive: “That’s such a minor part of this whole picture.” He said the provision was a “talking point for the Obama administration” rather than “a significant piece of policy.”

KEYES: What do you make of the millions of young people and seniors who are seeing some of the benefits already and would have those obviously stripped away if the bill were to be repealed?

KING: I can’t imagine there being any seniors who have seen any benefits of Obamacare.

KEYES: I guess in terms of the donut hole being closed.

KING: That’s such a minor part of this whole picture. I’ve had no constituents come to me and say, “it’s so good that the donut hole is closed.” I haven’t heard that subject even brought up in six months. That is a talking point for the Obama administration but it isn’t a significant piece of policy.

Watch it:

In fact, closing the donut hole is a key part of making health care affordable for seniors. Before health reform was passed, Medicare only covered prescription drug costs between $0-$2,700 and anything over $6,154. However, seniors were forced to pay for the entire cost of their prescription drugs between $2,700 and $6,154 with no Medicare coverage, presenting a major hardship for many older Americans.

The Affordable Care Act will phase out that donut hole over the following decade, allowing millions of seniors to afford the care they need. The benefits are already apparent; new data from the Centers for Medicare & Medicaid Services shows that “nearly 1.3 million people have received a 50 percent discount on their brand name prescription drugs when they hit the donut hole, saving a total of $660 million so far this year.”

Yesterday, Mitt Romney addressed a group of demonstrators protesting Medicare cuts outside of a town hall in The Villages, Florida. “I saw some signs out there, you may have seen them, that said ‘Keep your hands off our Medicare’” Romney said, “By the way, there’s only one person I know of that has cut Medicare. That’s the president of the United States.”

This is really wrong on two very, very big counts. First, Paul Ryan’s Medicare plan, which Romney applauded back in April, maintains the $500 billion in Medicare and Medicaid savings that are part of the Affordable Care Act and goes much further in shrinking the program. Second, many presidents have made changes to Medicare since 1965, including Republican idol Ronald Reagan who instituted a series of reforms that are strikingly similar to some of the payment changes included in the Affordable Care Act (policies Romney now refers to as cuts or price controls.)

For instance, Reagan adopted DRGs or Diagnosis Related Groups for paying hospitals under Medicare. As David Henderson explains, “the idea was to get out of cost-based reimbursement, which gave an incentive to have high costs, and replace it with a system of prices,” in which hospitals were paid a pre-determined rate for each Medicare admission. “But what made it a system of price controls was that the government, along with DRGs, made it illegal for hospitals to charge even a penny more than the price the government came up with.” As a result of the changes, Medicare saved $49 billion by 1986, far exceeding what even the Congressional Budget Office had predicted.

As millions of Americans continue to struggle in the worst economy since the Great Depression, keeping up with rising health care costs has become an all-too-common problem. Low-income Maine residents who don’t have insurance have found a novel way of getting the health care services they need: bartering for them by offering to do yard work or other chores. NPR reports on a program that hopes to inspire other health clinics to consider alternative means of payment in difficult times:

Deb Barth is raking leaves for Lesley Jones. But Barth isn’t earning money for her yardwork, at least not in physical currency. She’s earning “time dollars” — for every two hours she spends doing odd jobs, she’ll earn a free visit with her doctor.

As a struggling artist, Barth’s income qualifies her for the program at True North, a nonprofit health care clinic in Falmouth, Maine. She’s one of 33 patients who pay with time dollars there.

“I do things like deep cleaning, organizing,” Barth says. “I also offer caregiver support for people who may be caring for an older parent.”

So how does her doctor cash in these time credits? By getting free services from any of the other hundreds of people who belong to The Portland Hour Exchange Program.

Tom Dahlborg, the executive director of True North who used to work in Medicaid, says the program has many benefits. He noticed when people were receiving free care through Medicaid they would often feel guilty and undeserving of good treatment, so they would settle for less than what they needed. But patients who pay through time dollars work hard for their care, and as a result, are more fully engaged.

Another enormous benefit is the program cuts through the red tape that Medicaid beneficiaries increasingly have to contend with as Republican legislators enact more requirements, tests, and eligibility restrictions. Therapist Jennifer Lunden works with True North as well as the state’s Medicaid program and says, “For me, the biggest burden of taking especially MaineCare is the amount of paperwork and the amount of hoops that need to be jumped through.”

The program is commendable for accepting the types of payments that poor participants can offer, and organizing it into an efficient system. But it also has limitations, which highlight the need for a more inclusive health care system that doesn’t leave millions out in the cold to fend for themselves.

Dahlborg says that while there are no shortage of eager patients, finding doctors who are willing to go outside the system and barter for health care has been a challenge. And if patients without insurance need specialized or emergency care that True North can’t offer, they have to go elsewhere and pay out of pocket. They also have to leave the program if their income goes up too much.

A group of Republican senators and representatives convened on the Senate Swamp this morning to present 1.6 million petition signatures “from American citizens who are urging Congress to immediately repeal Obamacare.” The lawmakers argued that health care reform has undermined job creation and pledged to repeal the law before the Supreme Court rules on its constitutionality in the summer of 2012.

Rep. Louie Gohmert (R-TX) went a step further, suggesting that the justices should find the law unconstitutional in order to protect their own medical privacy:

GOHMERT: If the Supreme Court is really weighing from a personal standpoint, ‘gee do we strike it down or not?’ There is good news for them. In the Obamacre bill, any president they don’t like will have access to any Justice’s health care records and as I understand — I haven’t read the agreement between the administration and GE — GE will have access to their health care records. So a good not for the Supreme Court, all of their medical records will be available to the people they don’t like in the federal government. Good news for them if they don’t strike it down.

Watch it:

It’s unclear which provision Gohmert is referring to, but some Republicans have recently raised concerns about a regulation that would require insurers to send patient information to the government. The rule — which is not yet finalized — is the result of a provision in the law that establishes a “risk adjustment” mechanism to compensate insurers who take on too many sick patients. HHS is currently soliciting comments from the health care industry and the general public about how best to bolster patient confidentiality, but the Affordable Care Act specifically prevents the president or anyone else from obtaining personal medical information. The law requires HHS to obtain “de-identified claims” that would that could not be attributed to individual patients.

Sen. Bernie Sander (I-VT) pledged to oppose any effort to raise the Medicare eligibility age last night as he addressed Campaign for America Future’s Take Back The American Dream conference, arguing that too many Americans are already dying from poor access to health insurance:

“Forty-five thousand people are dying in America this year because they don’t have access to healthcare, and we’ll be damned if we’re going to allow more people to die by raising the eligibility age from 65 to 67,” Sanders told a liberal crowd gathered in Washington for the Take Back the American Dream conference. “Ain’t gonna happen.”

The Vermont liberal sounded a similar warning regarding proposals to scale back Social Security benefits.

“In the middle of the worst recession since the Great Depression, you know what you don’t do?” Sanders asked. “You don’t cut Social Security – that’s what you don’t do. And anybody who tells you that Social Security is part of the deficit problem is lying to you.”

Gradually raising the Medicare eligibility age had been initially considered by President Obama as part of larger deficit proposal, but was left out of his most recent deficit reduction plan. Sens. Joe Lieberman (I-CT) and Tom Coburn (R-OK) re-introduced the idea in their recent Medicare reduction proposal and have urged the super committee to adopt it. Hospitals have also been big boosters of the proposal.

But as Sanders put it, raising the age would increase costs for beneficiaries by moving seniors into more expensive private care and could potentially price some out of coverage altogether. The reform would save very little money and would only do so “by shifting costs to most of the 65- and 66-year-olds who would lose Medicare coverage, to employers that provide health coverage for their retirees, to Medicare beneficiaries, to younger people who buy insurance through the new health insurance exchanges, and to states.”