While the Senate Judiciary Committee voted to send S. 744, the Border Security, Economic Opportunity, and Immigration Modernization Act, to the Senate floor for a vote, the Bill still faces significant challenges from House GOP opposition. For example, some GOP House Representatives have proposed mandating that undocumented immigrants buy health insurance at a market rate in order to receive immigration benefits, not unlike the individual mandate of the Affordable Care Act—something that Republicans challenged before the Supreme Court as unconstitutional. So why do these Reps now want to force such a policy on undocumented immigrants? It boils down to a fear that has been written into our immigration code since nearly the turn of the 20th Century; that immigrants take advantage of public benefits to the detriment of the national economy, and thus become “public charges.” Under current law, immigrants who use certain public benefits, and who earn less than the Federal Poverty Guidelines, run the risk of becoming inadmissible or ineligible for immigration benefits. The result of this system ostracizes indigent and disadvantaged immigrants from obtaining relief and moving out of poverty. Yet some politicians would like to make these hurdles higher.
Nowhere in the definition of Public Charge, to date, has using a public health insurance program triggered the “public charge” problem. Yet the term is being thrown about liberally among some GOP Reps as they voice concerns about S. 744, and propose to expand the definition even more. What these House leaders are mostly concerned about (or at least the guise under which they are pontificating) is a need for “individual responsibility.” They want immigrants to prove that they can take care of themselves and won’t be a burden to the state. But this fear is just not based on fact. In fact immigrants are contributing billions to Medicare and paying in money, while American citizens are just draining it. A recent study lead by Harvard Medical School found that “immigrants generated surpluses totaling $115 billion from 2002 to 2009,” while “[i]n comparison, the American-born population incurred a deficit of $28 billion over the same period.”
So not only are these Reps decrying responsibility without supporting facts, but their demands reveal a sheer hypocrisy given the heated battle that was recently weathered in the Supreme Court over the individual mandate of the Affordable Health Care Act. And, during the fierce debates prior to the Affordable Care Act becoming law, these same GOP members fought tooth and nail to amend that bill and make sure that the undocumented would not reap the benefits of the new law, leaving them behind in the shadows.
Under the Affordable Care Act, only immigrants who are lawfully present can take advantage of health care provisions. Undocumented immigrants receive no federal coverage. They are not allowed to purchase private health insurance at full cost in state insurance exchange. They are not eligible for premium tax credits or lower copayments. They are exempt from the individual mandate. They are not eligible for Medicare, nonemergency Medicaid, or CHIP. But, they are eligible for emergency care, which is arguably more costly to society than allowing them to have benefits, since emergency care is extremely expensive and medical bills often go unpaid.
The GOP Reps claim to desire individual responsibility by requiring undocumented immigrants to purchase their own health insurance, and meet higher public charge standards, but have left them out of the Affordable Health Care Act. The cost of purchasing health care, without the aid or protection of the Affordable Care Act, is prohibitive to indigent immigrants. The only result of these raised barriers in the pathway to citizenship for the undocumented will be the exclusion of the poorest, most desperate, and possibly some of the most deserving people who comprehensive immigration reform seeks to protect. These proposals will only fuel the perpetuation of an underclass of undocumented immigrants who must live in the shadows.