As U.S. President Barack Obama signed the "fixit" legislation that put the final seal of Congressional and executive approval to the health care reform package, a sense of frustration and disappointment is settling in among legal and undocumented immigrants.

Their concern is being expressed in the form of a question: Why were so many immigrants, some legal residents and others undocumented, left out of the reform package and what does it say about the prospects of immigration reform later in the year?

"When we talk with immigrant constituents about the health care reform bill, many express excitement about the reforms that will benefit so many people. And yet there remains a deep sense of unfairness and disappointment when trying to understand why the most vulnerable legal immigrants, who have played by the rules and pay the same taxes as citizens, do not have access to the most affordable insurance available, Medicaid," Chung-Wha Hong, executive director of the New York Immigration Coalition, said after the passage of the historic bill.

The immigrants are also asking, Hong added, "why undocumented workers are not allowed to buy a private good with their own money that would keep them and their families healthy. Many are ashamed that the great country of the United States could do no better."

Dr. Marco Mason, who heads the Panamanian Council of New York, was equally perplexed.

"Access to health care is essential and the fact that the undocumented were left out of the reform underscores a significant weakness," said Dr. Mason, a long-standing immigration advocate. "We are also talking about immigrants entitled to Medicaid who have been by-passed.

"What the exclusion emphasizes is the need for the public option, which unfortunately was omitted from the final version of the package.

"It would have made sense to have included immigrants receiving Medicaid because it would help to provide access to a segment of society that's extremely vulnerable and often have to rely on the emergency room for care.

"Far too often that delay ends up in death."

Yvonne Graham, Brooklyn's Deputy Borough President, said that access to care should be "seen as a right" and excluding any group from its provisions wouldn't be in the public interest.

Like Graham, Dr. Milton Haynes, a former president of the New York County Medical Society, the second of two Blacks to have headed the 5,000 organization of physicians, agreed.

"Millions of hard-working people who have paid their taxes have been denied access to health care and that's not how it should be," said Haynes, a prominent Manhattan obstetrician/gynecologist. "I firmly believe access is a right and leaving out the undocumented was wrong. After all, when they become ill they can go to an emergency room and receive care regardless of ability to pay. In the end the taxpayers would pay. It really doesn't make sense in a nation that's really a country of immigrants."

Dr. Edward Alleyne, president of the Caribbean-American Medical and Scientific Organization shared Dr. Haynes' concern.

"Immigrants should have the access to care, pure and simple," he told the Carib News.