When it comes to the question of illegal immigrants receiving health care, passions can run high. There are a lot of considerations. Basic humanity, as well as the hippocratic oath, requires doctors to treat patients in need of urgent or life-sustaining care. It doesn’t matter if they can pay for it or if they are in this country illegally. But, of course, you don’t want people coming to this country for the sole purpose of receiving emergency care (to have a baby, for example). Be that as it may, there are millions of undocumented people in this country. And just as we face a conundrum when dealing with undocumented people wanting to drive, we have to deal with the fact that they will get sick and need care. If they can afford to buy health insurance, they should not be barred from purchasing it. Whether or not U.S. taxpayers should provide subsidies for undocumented people who cannot afford health insurance is a more contentious matter. Wherever you come down on that issue morally, there can be no doubt that providing subsidies in these cases would be politically unpopular in the extreme.
If undocumented workers are subject to the mandate, as some of them appear to be in HR3200, that would present a bit of a problem. Why? Because, as Jed Lewison notes, Section 246 of HR 3200 provides:
SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
Congress is going to have to iron out their definitions to make sure that they don’t create a class of people who are mandated to get health insurance, but who are barred from receiving affordability credits. William Jacobson sees this as a problem, too.
It also would be interesting to see how long the exclusion of illegal aliens from getting the credits lasted, since as the CRS notes, illegal aliens are subject to the health care mandate; one can anticipate the argument that if the House Bill requires illegals to have qualified health insurance, some accomodation needs to be made for those who cannot afford it.
Absolutely. And since it is politically impossible to create direct subsidies for undocumented workers, the only solution is to exempt them from the mandate.
What nobody seems to know when discussing this issue is that Mexico is well on it’s way to having free medical care for all.
http://en.wikipedia.org/wiki/Health_care_in_Mexico
They have already done the ‘all children’ and ‘pregnant women’ phases. So it is more likely that Mexicans who are undocumented will be returning to Mexico for their medicine.
I don’t think that means what republicans would like it to mean about our health care.
nalbar
Yeah, I think the main motivation for coming here to give birth would be the automatic American citizenship conferred on babies born in the States. As a health matter (except, perhaps, in some problem pregnancies) or a cost matter, it wouldn’t make sense.
And, of course, they get green cards to care for the US Citizen who cannot be deported or separated from his/her parents. Our immigration policy is wacky. The Constitutional amendment that made birth absolute automatic citizenship is more than 100 years old. It needs updating in a world where you can reach anywhere in two days. Pregnant Chinese lady on her way to a job in Germany gets labor pains at O’Hare Airport and gives birth prematurely at Cook County Hospital. Child is now a US Citizen. Insane! One of my grandmothers was born like this (on arrival day) in the U.S.A., but her parents were registered immigrants who came to stay. Intent MUST be part of the definition.
I’m the first to say that I don’t know the answer. We don’t want generations of non-citizens like the German-born “Turks” who grew up in Germany, sometimes their parents and grandparents were born and grew up in Germany, but still aren’t German citizens. But I do know that what we have has to change because of modern technology.
As for myself, I don’t care one bit how many become citizens this way. Why care?
nalbar
That is too funny.
Let the flood of undocumented Americans looking for health care begin.
I live in San Diego County, and trust me, a LOT of Americans go over the border for health care in Tijuana. Particularly dental work (disclaimer; my wife is a dentist).
Thousands, if not millions, go over to fill prescriptions.
nalbar
Inconceivable!
Hey – they already get hit with Social Security taxes they can’t collect when the illegals use someone else’s Social Security number. I think if they’re here illegally, they’ll find their own ways around the system. Let’s not make it easy.
I’m all in favor of legal immigration, and wish the system was a little more prompt in that regard. And I’m all for treating anyone who has an accident here and worrying about payments later. But I don’t want to give a completely free ride to someone who is not a citizen. Does that tarnish my credentials as a progressive? I hope not.
I don’t think so. I think most people feel the same way.
“Congress is going to have to iron out their definitions to make sure that they don’t create a class of people who are mandated to get health insurance, but who are barred from receiving affordability credits.”
Why? If they are illegal aren’t they by definition already breaking the law? What is the need to accommodate one form of law breaking over others? If they can afford to buy it they buy if they can’t or they don’t, they are what’s the word? Oh yeah illegal. Just like a citizen would be.
I see a greater argument for ending the federal ban on abortion than some provision to give illegals a chance at a federal subsidy.
The illegal immigrant problem in the Health Care Reform bill, from the Republican point of view, can only be resolved by writing into law a specific requirement that citizenship documentation must be presented prior to receiving health care on any and all service levels. These Republican citizenship documentation demands become a real heavy duty thorny problem at the door to the hospital emergency room. Under current law hospital emergency rooms have to grant care to ANYBODY requesting health care services.
Now there are essentially two populations who will show up at the emergency room for treatment WITHOUT any documentation, citizenship or otherwise. Obviously the first group are the illegal immigrants, the group that the Republicans have been constantly yapping about. The other group are members of America’s homeless population. American citizens living on the streets obviously don’t have a residence or a mailing address and are most unlikely to have passports or other proof of citizenship in their possession.
The Republican Congressman was asked what about those people turned away from the emergency room for lacking the proper citizenship documentation. Where do they go to get help? His response was that they could go find one of those local storefront clinics, “a doc in a box” he called it. Unfortunately, he was never asked about the fact that most a homeless people walk around without a dime in his or her pockets, and therefore couldn’t pay for service at a “doc in a box” if they could find one. What the Republican Congressman was trying to say, was actually said over two centuries ago by Marie Antoinette. When asked what will the starving public eat, she replied, “Let them eat cake!” Aside from the callous disregard for human life exhibited by the Republicans, the emergency room problem still exists.
There are many illegals who do go to clinics for health services and pay the bill out of pocket. However, there are also many illegal men who send their wives, children, and mothers to the emergency room for care because they know they won’t have to pay a dime for their care. Thus the problem is how to stop exploitation of the free emergency room service for routine medical problems by illegals, but yet provide it for homeless American citizens.
It is important to realize that many American Veterans are also part of the homeless population. Many of these men are on the streets due to service connected physical and mental problems. If the Republicans get their way on the citizen documentation issue in the health care reform bill, these veterans will be turned away from receiving treatment in their own home towns. We need to force the Republicans to come up with a responsible answer to this citizen documentation, hospital emergency room quandary in the current health care reform debate.