U.S. Taxpayers Should Not Have to Pay for Illegal Immigrants' Healthcare

Daniel Stein is president of the Federation for American Immigration Reform.

As the long and complex national debate about healthcare policy has unfolded, there is still a good deal of disagreement among Americans about many aspects of the bills that are making their way through Congress. On one matter, however, there is overwhelming consensus: Eighty percent of Americans are opposed to including illegal aliens under a taxpayer-subsidized national healthcare plan, according to a June 2009 Rasmussen poll.

Americans recognize that extending the full range of benefits to people who have no legal right to be in the country is unjustified and would add billions of dollars to the cost of a healthcare overhaul. Taxpayers—at the federal and state level—already spend about $11 billion a year on unreimbursed care for illegal aliens.

When analyzing a previous version of a House healthcare reform bill, the Congressional Budget Office estimated that the average government subsidy per person would cost $4,600 a year, growing to $6,000 a year by 2019. According to estimates, covering illegal aliens would increase the amount American taxpayers are spending for healthcare for illegal aliens from $11 billion per year to $30 billion. That would rise to $40 billion per year by the end of the next decade. Moreover, these costs fail to take into account any increase in the illegal alien population during that time.

While federal law and basic human decency require that emergency care be provided to anyone in a life-threatening situation, there is no compelling legal or humanitarian reason to offer every medical service to persons in the country illegally. Doing so would either drive up costs for everyone else or add to the already staggering deficit—both of which President Obama and congressional leaders have vowed will not happen.

The Pew Hispanic Center estimated that in 2007, 59 percent of illegal aliens lacked basic health insurance. Assuming that percentage has not increased as a result of the recession, and using conservative estimates of the population, that would mean some 6.6 million illegal aliens are medically uninsured. These uninsured illegal aliens are far more likely to have incomes below 400 percent of the official poverty level, making them income eligible for the government affordability credits included in the healthcare reform bill approved by the House.

For many of the reasons expressed by advocates for illegal aliens, continuing to have millions in our country who lack health insurance and are unable to pay for care poses its own set of problems. Those issues can and must be addressed by enforcement of our immigration laws, not by forcing American taxpayers to absorb billions of dollars in additional costs.

Advocates for covering illegal aliens begin from the false premise that the presence of 11 million to 15 million illegal aliens in our society is an immutable fact. It isn't. Through the elimination of nonessential public services and benefits, greater cooperation on the part of state and local police, and a rational enforcement strategy that makes it difficult for employers to get away with hiring illegal aliens, the number living in the United States can be reduced dramatically.

Recent history has demonstrated that enforcement works. Even before the onset of the recession, stepped-up worksite enforcement, begun in 2007, resulted in the first declines in the illegal population in decades. Moreover, in states that have implemented their own immigration enforcement strategies, the results were even more dramatic. Arizona, which requires employers to use a federal employment eligibility program known as E-Verify and bars illegal aliens from receiving most state benefits, has reduced its illegal alien population by about one third.

Unfortunately, the Obama administration has moved in precisely the opposite direction. Rather than continuing strategies proved to reduce the illegal population, it has pursued policies designed to create pressure for a massive amnesty. On several occasions, Obama has acknowledged that providing healthcare benefits to illegal aliens is politically untenable with the American public. Yet, he has openly assured ethnic advocacy groups of his commitment to granting amnesty to current illegal aliens and then bringing them under the umbrella of a national healthcare system.

Aside from being equally untenable with the American public, granting amnesty to illegal aliens would do nothing to reduce the cost burden for their healthcare. Because of education levels and limited jobs skills among the illegal population, the majority would not see their incomes rise appreciably and would therefore qualify for large taxpayer subsidies under the reform bills before Congress.

Coming at a time of high unemployment and soaring government deficits, the debate about whether to provide these healthcare benefits serves to illustrate the enormous costs of our failed immigration policies. Immigration, legal and illegal, has been a driving force behind the growth of the medically uninsured population in the United States. Until we bring our immigration policies in line with economic and fiscal realities, we will continue to face Hobson's choices on this and many other key issues.

Four out of five Americans are opposed to including illegal aliens under a national healthcare system not because they lack compassion but because they understand we cannot maintain a system that invites millions to use services that must be financed by taxpayers or through increased government borrowing. If our national goal is to provide a high standard of care without breaking the bank, then we must limit access to citizens and long-term legal residents and enforce laws against illegal immigration.

Read why coverage for the undocumented is best in the long run, by Eric Rodriguez of the National Council of La Raza.

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