Even after the Patient Protection and Affordable Care Act is fully implemented in 2019, about 23 million Americans will remain uninsured. About one-third of these will be undocumented immigrants, according to estimates by the Congressional Budget Office.

This is by design. Illegal immigrants will not be permitted to buy insurance through government-run exchanges even if they pay with their own money. They will not get federal subsidies to buy insurance and will remain ineligible for Medicaid and Medicare; and even legal immigrants will have to endure a five-year waiting period before they can sign up for Medicaid.

During the health reform debate, there was not political space to compromise on any of these elements. (Remember Joe Wilson?) As a result, the Congressional Hispanic Caucus at times seemed ready to sink the legislation. But according to a good piece in Politico today, the caucus backed down because they were assured by congressional Democratic leaders and/or the White House that their health care priorities would be addressed as part of immigration reform.

Reports Politico’s Carrie Budoff Brown:

They signed on only after receiving assurances that their concerns would be rectified as part of the immigration reform battle, according to lawmakers, advocates and Hill aides.

“The expectation was that everybody knew it was unfair and that a new immigration bill would correct that,” Rep. Raul Grijalva (D-Ariz.) told POLITICO.

Asked at what level he received such signals, Grijalva said: “High enough to feel secure about it.”