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Health Care and Undocumented Workers

Health Care and Undocumented Workers

By Marshall Fitz - September 12, 2009

The health care town hall circus this August had a recurrent sideshow: the illegal immigration paper tiger. The well-scripted disruption tactics by antireform activists played up one patently false claim after another. One of the most prevalent was the ungrounded assertion that undocumented immigrants will receive health care benefits in legislation before Congress.

The coordinated efforts of status quo activists culminated in one of the more embarrassing public outbursts in recent memory: an elected representative shouting at the president during his prime time address to Congress and the nation. It will be a long time before we forget Representative Joe Wilson (R-SC), in a rabid froth, interrupting the president's speech to call him a liar.

Representative Wilson's charge-that the president's plan will cover illegal immigrants-mimics the talking points of antireform advocates. Those advocates have made clear that they will pursue any means-including false claims and ad hominem attacks-to derail both health care and immigration reform. Their allegation that undocumented immigrants will get benefits of any kind is a time-honored strategy of the status quo caucus to inflame a debate.

But this debate is too important to allow falsehoods to go unrebutted, so it's time (yet again) to set the record straight:

Falsehood #1: Illegal immigrants will get taxpayer benefits under the health care reform proposals under consideration.

Fact: Every proposal on the table explicitly disqualifies illegal immigrants from receiving federal benefits. See the Senate HELP Committee bill, Section 151 and the Energy-Commerce Committee bill, Section 246.

Falsehood #2: An ironclad citizenship verification mechanism will protect U.S. taxpayers and reduce costs by preventing illegal immigrants from receiving benefits.

Fact: Opponents of reform cite the defeat of the verification amendments to health care legislation during House committee markups as proof that "illegals" will benefit from health care reform. In fact, by defeating the overly restrictive amendments committee members preserved critical administrative flexibility in defining the most effective verification process.

Some verification process will be required under a new program to enforce the explicit prohibition on benefits to illegal immigrants. But we have already seen that certain citizenship verification requirements in the Medicaid and Medicare eligibility contexts have created obstacles for U.S. citizens while failing to identify undocumented immigrants or save taxpayer money. The implementing agencies must have the flexibility to establish processes that maximize participation by citizens while barring undocumented immigrants from the program.

Falsehood #3: Illegal immigrants are a vast part of the uninsured population and removing them will solve the health care crisis.

Fact: We have approximately 46.3 million uninsured people in this country, and less than 7 million of those individuals are undocumented immigrants. That means 40 million Americans are uninsured. Solving the illegal immigration problem-important in its own right-will not solve the health care crisis.

Falsehood #4: Illegal immigrants consume large quantities of health care resources.

Fact: Illegal immigrants are already ineligible for Medicaid and Medicare and will remain so under current proposals. Even legal immigrants are ineligible for Medicaid for a five-year period. Immigrants across the board use fewer health care resources-from fewer office visits to fewer emergency room visits-than U.S. citizens. The argument that illegal immigrants are the cause of our health care woes is simply untenable.

Ultimately, the only way to remove this distracting sideshow from the national stage is to enact comprehensive immigration reform. We can make debates about benefits to illegal immigrants an historical relic by requiring illegal immigrants to register, get screened, pay taxes, learn English, and earn citizenship. Health reform and immigration reform are both national imperatives. Unfortunately, both are under assault by the status quo caucus.

Opponents of health and immigration reform are in the minority and on the wrong side of history. But they have committed to using any method-including fanning the flames of fear-to stall progress. CAP will continue to fight those fires with facts and stand with the American majority in promoting solutions to the major policy challenges of this era.

This piece appeared here and is reprinted with permission.

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Marshall Fitz

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