As we predicted, the politics of immigration have been dragged into the politics of health insurance reform. It is now crystal clear that no issue of importance can be determined smoothly and comprehensively as long as 12,000,000 people live, work and raise children in the U.S. but float in limbo because of our broken immigration system.
The anti-immigration side, most of whom would oppose the president's approach to health care reform anyway, has lied to the public. Their claims that undocumented immigrants and their families would somehow benefit or even participate in a reformed health insurance system are patently false. Our current systems of public health insurance (Medicare and Medicaid) already do a very, very good job of excluding ineligible immigrants.
Adding additional documentation requirements would be repeating a mistake we made when documentation checks on Medicaid in 2006 prevented eligible citizens and especially children from accessing care. Rearranging already effective methods for screening out ineligible immigrants from government programs will cause additional problems for citizens and legal residents; such as those 11-13 million Americans with no driver's license, birth certificate, or passport who could be excluded from access to affordable health insurance under various proposals under consideration.
Reality is not the strong suit of anti-immigration advocates and Members of Congress whose approach to immigration is based on driving out or deporting 12,000,000 people and their families.
The real questions on immigrants and health insurance reform relate to citizens, legal immigrants, and children.
Tax-paying legal permanent residents and other legal immigrants are also in jeopardy because of existing rules that bar them from coverage for five years and because of new restrictions being considered as part of health insurance reform. Five years is a long time to have to rely on the emergency room for expensive coverage (that we all pay for) and it is a lifetime for a child. It is fiscally and socially wise to include all tax-payers equally in a reformed health insurance system.
Finally, every child in America, regardless of the immigration status of their parents, is extremely likely to work and raise children in this country and live out the rest of their lives here. Therefore, it is a wise investment to ensure that affordable health insurance coverage is available to children.
If our goal is to make sure as many people living and working in America are covered by affordable health insurance so that the cost to tax-payers of expensive uninsured medical expenses is reduced, then ignoring immigration status makes sense. However, at a minimum, we should make sure that all tax-payers who are legal residents or citizens have access to affordable insurance coverage and we should not bar anyone who can afford it on their own from purchasing it.
Health insurance reform and immigration reform are two separate but interrelated matters. The goal of health insurance reform should be making sure every tax-payer in the system has access to affordable coverage. Immigration reform should be about making sure that everyone who is living, working, and raising families in the U.S. is in the system and paying the full compliment of taxes. We need solutions on both fronts.