The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010 and has slowly been implemented over the past two years. If the President’s health care reform legislation continues to move forward we will see tens of millions of Americans gain health insurance and access to medical care at more affordable prices than before, yet due to some of the provisions of the ACA, almost 12 million people living in the United States will see no change to their access to health care. These habitants, most of them employed, come from outside the U.S., and therefore are defined as non-citizens by their immigration status. As a result, all undocumented immigrants and many legal residents will find themselves in a minority of American workers without the same rights and access to basic health needs. Using a multi-faceted approach to study the intersection of immigration and health care, this paper combines ethnographic interviews with immigrant small business owners in West Philadelphia with a literature review of the history of immigration reform and the theories behind the social concepts of political exclusion, framing, structural violence, and biopower. In the conclusion, explanations will be given for the continued biopolitical exclusion of immigrants in the U.S. and suggestions will be supplemented on how this country may be able to change its policy to one day have true universal health care coverage.