Fathom this:
"Obama wants every citizen to prove that they are insured, but people don't have to prove that they are citizens" . . . Ben Stein
As a recent article in Health Affairs predicts, once the health-care reforms settle in, undocumented immigrants will become the largest share of the uninsured.
*
The intersection of 'Obamacare' and
undocumented immigrants
The
Democrats' Affordable Care Act of 2010 — aka 'Obamacare' — could hasten
America's journey toward a more orderly immigration program, writes Froma
Harrop.
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Two
of the hottest topics on the political circuit are illegal immigration and
"Obamacare." They can come together into a third steaming discussion:
How the Democrats' Affordable Care Act of 2010 would hasten America's journey
toward a more orderly immigration program.
As a recent article in Health
Affairs predicts, once the health-care reforms settle in, undocumented
immigrants will become the largest share of the uninsured. As legal residents enjoy
universal coverage, those without would be more noticed. (The authors are
Stephen Zuckerman, Timothy A. Waidmann and Emily Lawton, all of the Urban
Institute's Health Policy Center.)
Contrary
to much propaganda hurled at the Affordable Care Act, the law guaranteeing
coverage to all Americans excludes illegal immigrants. It does not let them
join the expanded Medicaid program for the poor. It denies them low-income
subsidies to purchase coverage through the health-insurance exchanges. It even
bars them from buying affordable coverage through the exchanges with their own
money.
Illegal
immigrants might avoid enrolling their native-born children, who are citizens,
in Medicaid or the Children's Health Insurance Program, the article suggests.
While helping these children obtain the medical care they are entitled to may
be the right thing to do, it's undeniable that Affordable Care Act restrictions
shrink one incentive for coming to this country illegally.
Experience
suggests that illegal immigrants generally do not try or succeed in joining
public programs. For families with incomes below 133 percent of the federal
poverty level, there has been little difference in private coverage rates. But
the gap in public coverage is "dramatic." Within this low-income
group, one in four native-born Americans and one in five legal permanent
residents find coverage through a government program. Only one in 10 of the
undocumented immigrants does.
It's
a hard reality that the United States can't supply American-style health
services to any poor person who crosses the border. No country could. Even many
Americans can't afford American-style health care — a national disgrace that
Obamacare seeks to remedy. Canada unapologetically patrols its government
programs against unauthorized users, and so must we.
To quote the conservative
economist Milton Friedman, "It's just obvious that you can't have free
immigration and a welfare state."
Obvious,
yes, though I wish Friedman had used a less loaded word than
"welfare." Extending health-care security, supported by government
subsidies, is one way America can ease some of the growing inequalities
pounding its working class.
The
elderly enjoy government-guaranteed medical coverage, as do prisoners and the
poor. We don't call Medicare "welfare," even though it requires huge
transfers of taxpayer money. Why should the working poor — whether native born
or legal immigrant — be the only ones left in the cold?
The Affordable Care Act might
speed up "self-deportation," whereby a tougher environment for
illegal immigrants prompts some to return home. (That's already happening due
to a weak labor market and recent stepped-up application of the immigration
laws.)
Ideally,
strict enforcement would be paired with a last-time amnesty for otherwise
law-abiding illegal immigrants already here. Many have deep roots in this
country, and their American-born children know no other. These people would be
folded into the health-care program.
The
Affordable Care Act, "Obamacare" or whatever you want to call it, is
essential to America's well-being on several fronts. It will help curb rising
health-care costs. It will round some sharp edges in our freewheeling capitalistic
system: No longer will loss of job mean loss of health coverage as well. And
for those staunchly worried over immigration, it will darken the line between
legal and not legal.
Conservatives
opposed to illegal immigration should reconsider their vows to kill off the
health-care reforms.
Providence
Journal columnist Froma Harrop's column appears regularly on editorial pages of
The Times. Her email address is fharrop@projo.com
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