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The Long Wait for Affordable Health Care

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The health care debate is at a fever pitch as political voices are drowning out the common-sense principles that should be guiding the debate: fairness, dignity, and sound public health policy. Basic fairness dictates that if you pay your fair share, you should be able to receive what you pay for. Basic respect for human dignity requires that families and workers should not fear losing everything because of an unexpected illness or accident.

These principles should guide all aspects of health care reform. But for one large group of families, the health care system is deeply unfair. Legal immigrants are excluded from federal health care programs like Medicaid and Medicare for five years, even though they're paying the cost for these programs.

Most Americans believe that legal immigrants should be treated like citizens when it comes to health care services. However, current law requires that legal immigrants wait at least five years before they can apply for affordable health care coverage through Medicaid and Medicare -- coverage that is available to citizens with similar incomes. The policy is contrary to our national values of fairness and dignity and to the strength and prosperity of our nation.

These immigrants are working hard at difficult and often dangerous jobs, paying federal, state, and local taxes, and contributing to the social fabric of our communities. Like generations before them, they are making a crucial contribution to our nation, especially in these difficult economic times. And yet current federal policy singles them out for exclusion from systems designed to offer all of us affordable care in times of economic insecurity and old age. As a result, despite struggling to live the American dream, these workers and families live in fear that one accident or illness will leave them unable to care for themselves or their families.

The waiting period is especially unfair because these workers and families have paid into our Medicare and Medicaid systems, just as citizens have. They are doing all that's been asked of them, and yet they are being told to wait, at a time when the security afforded by these basic federal programs is especially important.

Because immigrants are a part of us--our neighbors, our co-workers, our friends and often our family members--excluding them from care harms not just individuals but our entire nation's health. That's why medical groups ranging from the American Academy of Pediatrics to the American Hospital Association have written to Congress and President Obama, imploring them to repeal this unfair and unworkable policy. They point out that immigrants subject to this waiting period are often uninsured, requiring them delay medical treatment until their condition worsens.

With fairness, dignity, and public health at stake, why has Congress failed to remove this waiting period? Proponents of the ban claim that it's necessary to discourage people from immigrating to the United States in order to receive government benefits. But that's a smokescreen. Ample research makes clear that immigrants come to the United States, as they have since the nation's founding, to pursue opportunity and freedom. In fact, new immigrants are less likely to use health care and related government services than are citizens, not more.

Earlier this year, Congress and President Obama recognized this reality and determined that five years was too long for legal immigrant children and pregnant women to wait for medical care. Removing the waiting period under the Medicaid and Children's Health Insurance Program allowed children and mothers to have access to vital medical services during these critical times, and has undoubtedly improved our nation's public health in the short and long-term.

It is now time to offer the same basic access to all legal immigrants as we do for all citizens. By making sure that everyone who contributes has equal access to health care, we will create a system that is fair and effective. No one should have to wait for five years before getting screened for cancer or treated for asthma. Removing the waiting period is a workable solution that will uphold our values and move us forward together.