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Health Insurance and Immigration Reform – Separate but Inter-Related


Monday, September 28, 2009
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The Senate Finance Committee has begun marking-up health care reform
legislation introduced by Sen. Max Baucus (D-Mont.), a process that
could take several days. Ali Noorani, Executive Director of the
National Immigration Forum, a non-partisan, non-profit pro-immigrant
advocacy organization in Washington, says now immigration politics have
become part of the health care debate. 

As we predicted, the politics of immigration has been dragged into the
politics of health insurance reform. It is now crystal clear that no
issue of importance can be determined smoothly and comprehensively as
long as 12,000,000 people live, work and raise children in the United
States but float in limbo because of our broken immigration system.

The anti-immigration side, most of who would oppose the president’s
approach to health care reform anyway, has lied to the public. Their
claims that undocumented immigrants and their families would somehow
benefit or even participate in a reformed health insurance system are
patently false. Our current systems of public health insurance
(Medicare and Medicaid) already do a very, very good job of excluding
ineligible immigrants.

Adding more documentation requirements would be repeating a mistake we
made when documentation checks on Medicaid in 2006 prevented eligible
citizens, and especially children, from accessing care. Rearranging
already effective methods for screening out ineligible immigrants from
government programs will cause additional problems for citizens and
legal residents; such as those 11 to 13 million Americans with no
driver’s license, birth certificate, or passport who could be excluded
from access to affordable health insurance under various proposals
under consideration.

Reality is not the strong suit of anti-immigration advocates and
members of Congress, whose approach to immigration is based on driving
out, or deporting, 12,000,000 people and their families.

The real questions on immigrants and health insurance reform relate to citizens, legal immigrants, and children.

Tax-paying legal permanent residents and other legal immigrants are
also in jeopardy because of existing rules that bar them from coverage
for five years and because of new restrictions being considered as part
of health insurance reform. Five years is a long time to have to rely
on the emergency room for expensive coverage (that we all pay for) and
it is a lifetime for a child. It is fiscally and socially wise to
include all tax-payers equally in a reformed health insurance system.

Finally, every child in America, regardless of the immigration status
of their parents, is extremely likely to work and raise children in
this country and live out the rest of their lives here. Therefore, it
is a wise investment to ensure that affordable health insurance
coverage is available to children.

If our goal is to make sure as many people living and working in
America are covered by affordable health insurance so that the cost to
taxpayers of expensive uninsured medical expenses is reduced, then
ignoring immigration status makes sense. However, at a minimum, we
should make sure that all tax-payers who are legal residents or
citizens have access to affordable insurance coverage, and we should
not bar anyone who can afford it on their own from purchasing it.

Health insurance reform and immigration reform are two separate but
interrelated matters. The goal of health insurance reform should be
making sure every taxpayer in the system has access to affordable
coverage. Immigration reform should be about making sure that everyone
who is living, working, and raising families in the U.S. is in the
system and paying the full compliment of taxes. We need solutions on
both fronts.

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