What Would Giving Health Care to Undocumented Immigrants Mean?


Providing comprehensive health coverage to undocumented immigrants has long been nothing more than a wouldn’t-it-be-nice item on the far left’s wish list. But in the crowded field of candidates vying for the 2020 Democratic presidential nomination, nearly everyone supports it.

Almost all of the 19 candidates who responded to a recent New York Times survey on health care positions said “yes” to a question about whether undocumented immigrants should be covered under a “Medicare for all” system, a public option or other government health programs. And during the second night of the Democratic debates last week, the idea received a unanimous show of hands in support.

President Trump was gleeful, predicting that the response would prove politically toxic for his opponents.

“All Democrats just raised their hands for giving millions of illegal aliens unlimited healthcare,” he wrote on Twitter. “How about taking care of American Citizens first!? That’s the end of that race!”

On the debate stage last week, Mayor Pete Buttigieg of South Bend, Ind., said that unauthorized immigrants contributed to society by paying property and sales taxes. Although many undocumented workers are paid off the books, others do have taxes withheld by employers and therefore help fund health care programs for which they are ineligible.

They tend to underuse health care, especially since the Trump administration has cracked down through raids and deportations. Fear has been keeping them away.

“The majority of their children are United States-born citizens who may qualify for Medicaid and CHIP coverage,” said Samantha Artiga, who directs the disparities policy project for the Henry J. Kaiser Family Foundation. “But parents are often fearful of enrolling their children, even though they are eligible, because they don’t want to put the rest of the family in jeopardy.”

The federal government can deny legal residency status (commonly known as a green card) to anyone considered likely to become a “public charge”— meaning a drain on public resources.

Under longstanding policy, Medicaid, the federal-state health program for low-income people, was not considered a public benefit for these purposes. But last year, the Trump administration proposed a rule, now in its final stages, saying that Medicaid use would be a “heavily negative factor” counting against someone trying to obtain a green card.

No one seems to have envisioned a program that would allow for medical tourism. Some independent experts have suggested a residency requirement before people can apply for Medicaid, to prevent the appearance of health care as an immigration incentive.

Randy Capps, a senior researcher at the Migration Policy Institute, said: “They are driven primarily by work opportunities and, more recently, dire climate, economic and security conditions. Health coverage is unlikely to change the equation given these much bigger migration push and pull factors.”



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