Everyone benefits if illegal immigrants are insured

USA TODAY
November 12, 2009

Remember this little heath care drama from September?

President Obama, addressing Congress: "There are also those who claim that our reform efforts would insure illegal immigrants. This, too, is false."

Rep. Joe Wilson, R-S.C.: "You lie!"

Hardly a great moment in American political discourse. In fact, it seemed to symbolize how far the quality of civilized debate has fallen. But the noise over illegal immigration and health care reform hasn't gone away, so let's take a look at the substance.

All versions of medical overhaul would bar illegal immigrants from getting any federal subsidy or participating in the so-called public option, if there is one. But there is a significant difference between the plan passed by the House last week and language in the main Senate bill: The House would let illegal immigrants buy insurance on newly created exchanges. At full cost. With their own money. The measure approved by the Senate Finance Committee would not.

The House approach is far superior, not just for immigrants but for society as a whole. Just as the public is better protected when illegal immigrants buy auto insurance, the same goes for health coverage.

Illegal immigrants with the means to buy medical policies should be encouraged to do so in the exchanges, not chased away. Their premiums would help cover costs for everyone else, including older workers, those with previous medical conditions, and women who pay through the nose for maternity coverage if not part of a large pool.

Fact is, illegal immigrants without insurance will continue to get sick. They will continue to receive care in hospital emergency rooms and clinics, both of which are supported directly or indirectly by taxpayers, the insured population, or both. That being the case, wouldn't we want to encourage those who can help defray the costs to do so?

Opponents fixate on the government role in setting up the exchanges, "stores" where private companies could offer policies. True, taxpayer money would go to create these marketplaces. But these fixed costs would not go up in any measurable way if illegal immigrants participated.

Actually, the opposite is true. Weeding out illegal immigrants from the exchanges could be expensive. The costs of checking records would have to be borne by policy holders or taxpayers. And the hassles of proving your legal status could dissuade some legal residents and citizens from buying insurance.

Such checks would, of course, be imposed on people looking for government assistance -- and rightly so. But they should not be imposed on paying customers. Department stores don't purposefully delay their customers at the checkout line. Why should insurers be forced to?

For all the political heat surrounding this issue, in truth it would not affect a huge segment of illegal immigrants. According to the non-partisan Migration Policy Institute, of the estimated 12 million unauthorized people in this country, about 3.7 million have insurance through an employer. That would not change as the result of health reform. About 7 million have no insurance at all, and some 362,000 or so buy insurance outside of work. Only the last group, plus the small segment of uninsured who have the means to buy insurance, would be effected.

Illegal immigration is a serious problem. It should be stopped. For the moment, though, the question is: Do we want to benefit from the immigrants' presence here? Or do we want to get so hung up on the politics of immigration that it leads to warped and nonsensical public health care policies?

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