The Immigration Debate Can Wait; Healthcare for All Cannot

Eric Rodriguez is vice president of the National Council of La Raza, where he heads the Office of Research, Advocacy, and Legislation.

The fight over legal and undocumented immigrant inclusion in a reformed healthcare system has been brewing for months but has recently intensified. Anti-immigrant politicians have called the president a "liar" over the question of whether or not his plan would give benefits to "illegal aliens." But rather than expose these politicians for fearmongering, honest health-reform negotiators have inadvertently legitimized the claims. Efforts by Senate negotiators to tighten health proposals and prevent unauthorized residents from accessing new benefits now border on the ridiculous. Reformers have overreacted, and desperation for political cover may well take us down a perilous path.

Anti-immigrant politicians argue that undocumented people should be excluded from the proposed taxpayer-subsidized health insurance exchange. The president agrees, and Senate legislation does exactly this. But the health exchange is a structure, more akin to the Internet and our road systems, not a government benefit. Who would argue we should erect barriers to our roadways for unauthorized workers? Should we also prohibit undocumented immigrants from buying food in a grocery store or medicine at a pharmacy? In both cases, taxpayer dollars are used to support regulation of products sold in these markets. More workers in the health exchange will help control healthcare costs and ensure that Americans are not exploited when purchasing health insurance.

And what about the more than 1.5 million undocumented children in the United States? Under the Senate healthcare plans, a child who was involuntarily brought to the country at the age of 2, for example, and is now 14, loves the Jonas Brothers, and gets straight A's in school would be prohibited from participating in the exchange.

Unauthorized workers and children are already barred from Medicaid, and health reform continues the ban. But under current law, if the parents of an undocumented child can afford to buy private insurance with their own money, they can. If the Senate restriction becomes the law of the land, 650,000 undocumented children without health insurance will be effectively barred from the most affordable private health insurance plans available. Health reform would make these children less secure.

Anti-immigrant politicians further argue that U.S.-born children of immigrants should not be given citizenship. Do you wonder what they believe about providing these American children healthcare? These politicians would punish citizen children and families with a working parent who is unauthorized. Negotiators seem to agree. Reformers would go overboard in crafting a complex web of rules to guarantee that the unauthorized parent of a family of four U.S. citizens cannot possibly benefit from health reform. In effect, the rules could mean that the entire family cannot afford health insurance because of a drastically reduced affordability credit.

Side by side, the new rules could mean that the government will treat a U.S.-born child of an unauthorized parent as less than a U.S.-born child of U.S. citizen parents. This unequal treatment among U.S.-born children might even be unconstitutional. One can make an argument that those in the country unlawfully should not receive direct government assistance. But no one can reasonably argue that Congress ought to institute laws that directly harm U.S.-born spouses and children of unauthorized workers in order to punish the workers. The cost of this overreaction is that American children and spouses in this boat—some 4 million children are in mixed-status families—could find themselves capsized without affordable healthcare options.

Politicians—including some who should know better—further argue that some categories of legal immigrants should not have access to Medicaid. Current law prohibits all legal immigrant adults from gaining access to Medicaid during their first five years in the country. To effectuate this, lawmakers have put in place bureaucratic red tape, verification, and citizen documentation rules that have been incontrovertibly proved to be costly and to harm eligible U.S. citizens.

Confusion over these rules also helps explain why more than 45 percent of all legal, taxpaying immigrants have no health coverage. Rather than fix this problem, health reform could make matters worse. The Senate bill maintains the bar on Medicaid for legal immigrants. True, families may be eligible for the new healthcare exchange, but negotiators are threatening to extend ineffective and burdensome verification and citizen documentation rules to the exchange.

If Congress caves to these anti-immigrant voices and makes it harder for U.S.-citizen or lawfully present children of immigrants to get health insurance, we ought to know what will happen. Children in these families will not have a regular doctor. Most will not have access to preventive care, diabetes screenings, or flu shots. When a child gets sick or hurt—which will happen—parents will first attempt to administer aid themselves, and when the condition has become unbearable and potentially life-threatening, the parents will have no choice but to take their child to an emergency room for costly care. Is this the health reform we seek for our children?