Here's a way to make the bloated costs of health care reform seem more palatable to opponents - it will knock 220,000 illegal immigrants out of the health care system just in California alone.

A new policy brief from the UCLA Center for Health Policy Research says up to 20 percent of all uninsured children in California are those of illegal immigrants, but even some who are here legally may not apply because of confusing rules in The Patient Protection and Affordable Care Act of 2010 (ACA) , known colloquially, thanks to pundits like Bill Maher and detractors in the debate, as ObamaCare. 

Using data from the 2007 California Health Interview Survey (CHIS), the study's authors estimate that under the ACA, approximately 30,000 undocumented immigrant children will be barred from participating in the Health Benefit Exchange, a newly established marketplace for health care plans with subsidies for lower-income Californians. Although their parents will be able to purchase private insurance outside of the exchange, they would not benefit from its protections or competitive prices.

In addition, approximately 150,000 uninsured children will be excluded from the ACA-funded Medi-Cal expansion due to their status as either undocumented immigrants or legal immigrants who have lived in the U.S. for fewer than five years.

They speculate that an estimated additional 40,000 children who are legal citizens of the U.S. also may be excluded from the ACA coverage expansions as a result of confusion over their parents' citizenship status. Specifically, parents who are non-citizens without a green card — who are themselves excluded from public programs and the exchange — may perceive that the documentation restrictions also apply to their qualified citizen children.   Without coverage, parents and children alike will likely fall back on community clinics, which have long been a source of care for illegal and new legal immigrant children. 

Although public coverage programs such as Medi-Cal and Healthy Families provide a safety net for more than 1 million immigrant children, including those here illegally children, state funding to cover this population may soon dry up due to California's ongoing budget crisis. 

"Health care reform restrictions raise some very unpleasant questions about our willingness as a society to let children go without care," said the study's lead author, Ninez Ponce, a faculty associate with the center and an associate professor at the UCLA School of Public Health. "And confusion over the rules may result in even eligible children being cut off from coverage."