Health Insurance and Immigration Reform - Separate but Inter-Related
New America Media, Commentary, Ali Noorani, Posted: Sep 23, 2009
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. IMMIGRATION MATTERS features the views of immigrant rights groups across the country.
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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User Comments
Jack on Sep 28, 2009 at 22:12:22 said:
Actually, healthcare and immigration should be separate issues. The inclusion of the "Immigrant" issue into health care only serves to to confuse the issue. In the plainest figures I can imagine, a Hispanic has costs of $850 annual in health care costs per year, which is about half that of the white americans, while the undocumented cost much less than that. It is the costs of Medicaid and Medicare which are breaking this country, do not confuse the issues.
nativessayno on Sep 25, 2009 at 09:35:06 said:
I happen to be American Indian with roots going back to the last Ice Age. You refer to me and citizens as Americans since that is our name. A map shows you borders too-don't like that reality? Too bad. I, for one have tremendous pride of country and proudly accept any/all citizens of every "stripe".
So on whose authority do you get to claim: "This land is for all as long as they want to work hard and make a better living!!"
That is true because you say it is? You are making a 'better living" at which American citizen's expense? I resent this very much, because, well, I am an American citizen and I speak with WAY more authority then illegal immigrants!
Every group commits crimes so condone or accept it? That is the most fractured logic I have seen to date.
Moral relativism and self-interested indignity, disingenoues mawkish claims do not make you suddenly legal and eligible for our GREAT democratic experiment.
Gratitute to our country and consideration of actual citizens would have made a far sounder and appealing argument for your claims. Otherwise, your evocative demands actually exclude us in your argument and demands of us.
Dredging up American Indian people's past to reconcile your rationale for pro-illegal immigrant causes expose your lack of understanding or the varied and inherent meaning of American history; or that we are here and remain here now. Sorry, that argument should actually embarrass you.
Continue to expect us to throw open our hard won rights from your baseless demands and see how we Americans like it and where that gets you.
Norski on Sep 25, 2009 at 07:42:37 said:
Stephane - Did you bother to look in the history books as to what really happened during the great waves of immigration that came between the Civil War and World War 1? Unemployment reached 32% in the unskilled labor economy by 1910 thanks to uncontrolled immigration. Worse than the Great Depression, when unemployment barely reached 25%! And unemployment of 30% in California resulted in the Chinese Exclusion Act. And Ellis Island was opened against a backdrop of unemployment so bad that it exceeded 50% in the states of Maine, Kansas, and Michigan. But like the Energizer Bunny of ignorance people keep equating the “immigrants stop coming” cries of the time as some form of evil racism and ignore the devastatingly high levels of unemployment. Since that time we learned that controlling immigration significantly lessens the possibility of massive, excessive immigration driven unemployment.
The heart of our current immigration system was designed by that Liberal Lion Teddy Kennedy. It is geared to let in Immigrants in a way that does not exceed our ability in the USA to create jobs. Just because the system does not let in everyone who wants to come to the USA does not mean that the system is broken. In fact, recent studies on Legal Immigrants show that the current system is amazingly successful at not creating unemployment due to excessive immigration. So is it morally wrong to try to stop Illegal Immigration because Illegal Immigrants bypass this system and threaten the whole employment picture? Or is it morally wrong to stop people from having their way in violation of the law even when it threatens the employment well-being of the rest of us?
Even when we reached the lowest levels of unemployment back in 2007, unemployment for young folks still topped 20%. And overall, we still had 12 million unemployed Americans, primarily centered in the unskilled labor markets while 7 million Illegal Immigrants were working in those same Labor Markets. If we are supposed to be progressive then why are Illegal Immigrant supporters advocating a return to the high unemployment, uncontrolled immigration days we left behind 100 years ago?
Factual Person on Sep 25, 2009 at 01:39:01 said:
Let me start by addressing the whole "tax paying" issue that is being debated by both sides.
Some of the illegal immigrants do pay taxes and some do not. Some do actually file and benefit from the returns as well. This I can say with an absolute certainty as I have seen the forms.
As far as all these people "mooching", I dont see how that is really possible. There are in fact more black americans using these services than illegal immigrants.
The problem I have with illegal immigrants is sending all the money to Mexico. The money they send back to Mexico goes to an already corrupt government, and some probably ends up in the hands of corrupt police officers with little or no training.
Many of them leave Mexico for many reasons. Some with a dream to make their houses and move back to Mexico rich. Very few end up doing this but some do.
Others want to get out of a bad area and serious poverty by finding a job here and going back with just enough to "get out". Then end up liking it here and want to become law abiding citizens that pay taxes. With the way things are becoming, those people may never be able to even come here to "not be a drain" on the so-called economy problems they are creating with healthcare.
The only things that they are doing to drain the economy is send money to a country that it doesn't belong and commit crimes.
As far as crime committing goes. Every race does that.
Now let me address the issue of who is really illegal. All of us here except for Native Americans are the truly illegal ones that do not belong. Including Latinos. None of us that are citizens today, by way of birth here, had a choice to be here.
We have to call somewhere home, and its obvious that the mother countries like England and Africa are not going to take us back now, so we now call this our home.
As far as classifying only US citizens as Americans, that is complete bullshit. Somebody pull out a map and look at what America is.... a continent so therefore everybody born on this continent is American.
Why do only US citizens get to call themselves Americans?
Now let me address the lack of education in Mexico. This exists even in their surgeons.
When there is a society that makes a living by quitting school, and not even knowing how to spell words in their own language, you know there is bound to be problems with those people in a society that values education.
Factual Person on Sep 25, 2009 at 01:37:11 said:
Let me start by addressing the whole \\\"tax paying\\\" issue that is being debated by both sides.
Some of the illegal immigrants do pay taxes and some do not. Some do actually file and benefit from the returns as well. This I can say with an absolute certainty as I have seen the forms.
As far as all these people \\\"mooching\\\", I dont see how that is really possible. There are in fact more black americans using these services than illegal immigrants.
The problem I have with illegal immigrants is sending all the money to Mexico. The money they send back to Mexico goes to an already corrupt government, and some probably ends up in the hands of corrupt police officers with little or no training.
Many of them leave Mexico for many reasons. Some with a dream to make their houses and move back to Mexico rich. Very few end up doing this but some do.
Others want to get out of a bad area and serious poverty by finding a job here and going back with just enough to \\\"get out\\\". Then end up liking it here and want to become law abiding citizens that pay taxes. With the way things are becoming, those people may never be able to even come here to \\\"not be a drain\\\" on the so-called economy problems they are creating with healthcare.
The only things that they are doing to drain the economy is send money to a country that it doesn\\\'t belong and commit crimes.
As far as crime committing goes. Every race does that.
Now let me address the issue of who is really illegal. All of us here except for Native Americans are the truly illegal ones that do not belong. Including Latinos. None of us that are citizens today, by way of birth here, had a choice to be here.
We have to call somewhere home, and its obvious that the mother countries like England and Africa are not going to take us back now, so we now call this our home.
As far as classifying only US citizens as Americans, that is complete bullshit. Somebody pull out a map and look at what America is.... a continent so therefore everybody born on this continent is American.
Why do only US citizens get to call themselves Americans?
Now let me address the lack of education in Mexico. This exists even in their surgeons.
When there is a society that makes a living by quitting school, and not even knowing how to spell words in their own language, you know there is bound to be problems with those people in a society that values education.
Stephane on Sep 24, 2009 at 22:25:00 said:
I personally thing it is sad to read some of the posts on this website. My ancestors came to this country in 1871 and I do not think they had a passport or a visa or anything like that. All the hatred that some of us are directing towards immigrants is just pathetic. This is the same hatred many of our ancestors went through. If you're not Native American, then it is wise for one to just shut up and look at his/her own history to realize that we all came here to better our lives. And my ancestors were victims of discrimination when they came here too. So, instead of coming on this wbesite and posting anti-immigrant rhetoric, people need to find out about their own family history and maybe go back to where they are from. Then, they might be in a position to tell new immigrants (legal or illegal, because our families did not all come here legally) to leave this country! America belonged to the indians first, and their land was taken away from them! This land is for all as long as they want to work hard and make a better living!!
Bert Jones on Sep 24, 2009 at 11:15:53 said:
"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."
I'm sorry but wouldn't adding e-verify as mandatory help to bring legal U.S. Citizens in to the present? So what if there may be mistakes with the system and that it may cause some people delays. Illegals are the least of our concern. They should be put at the end of the line. Citizens need to get their paperwork together. If this forces them to fix errors all the better.
Illegals, not our concern. Go home and try again. Sorry, but it's only right.
Norski on Sep 24, 2009 at 07:00:49 said:
According to the U.S. Bureau of Labor Statistics Report released on September 4, 2009:
Farming, fishing, and forestry occupations – Unemployment Rate = 15.6%
Construction and extraction occupations – Unemployment Rate = 17.0%
Production occupations – Unemployment Rate = 15.1%
Transportation, material moving occupations – Unemployment Rate = 11.8%
Service occupations – Unemployment Rate = 10.0%
Total Unemployed Citizens and Legal Residents of the USA = 14,928,000
In addition:
Persons who currently want a job but are not included in the unemployment figures because they have not looked for a job in the last month = 5,609,000
Estimated number of Illegal Immigrants working in the USA = 7,500,000
Meanwhile:
Management, professional, and related occupations – Unemployment Rate = 5.4%
Those who claim that Illegal Immigrants are “just doing jobs that Citizens and Legal Residents will not do” cannot justify such claims in the face of the real statistics. And if you look at these same statistics back when unemployment was at its lowest, back in early 2007 there still were over twelve million unemployed Citizens and Legal Residents of the USA versus about seven working Illegal Immigrants.
The claim that without Illegal Immigrants the USA would have less tax revenue is a statistical misrepresentation perpetrated by those who would have us believe that if currently working Illegal Immigrants left the USA they would take the jobs with them. But in fact, those jobs would still exist and recent history has proven that after job site raids companies fill their open positions with Citizen and Legal Resident workers. Thus there would be no loss in job related tax revenue if Illegal Immigrants had never come to the USA.
And what of the claims of a supposed economic loss without Illegal Immigration? What of food expenditures? We would be exporting food instead of selling it locally. The USA is only one of a handful of net food exporters and people do not stop eating just because they are in another country. Clothing? We import most of out clothing so where is the loss in domestic jobs? Transportation? Aren’t we trying to reduce our gas usage? Consumer goods? These are bought with the disposable income one gets with having a job. Unemployed Citizens & Legal Residents getting jobs would replace this spending.
Considering ALL the aspects of Illegal Immigration and its effects on our economy, it is very evident that far from being an economic boon to the USA, Illegal Immigration is actually a cost drag. It increases the use of government services by creating Citizen Unemployment and reduces disposable income by driving down wages.
Norski on Sep 24, 2009 at 06:35:53 said:
What does emergency room data really say? The most recent year of complete Center for Disease Control statistics regarding Emergency Room (ER) Admittances is 2004.
Using contemporary USA Census and Pew Center Illegal Immigration data from 2005 sets the base line. One finds that 78% of the 11.1 million Illegal Immigrants living in the USA in March 2005 were classified as coming from Mexico & Latin America (Hispanic) per Pew Center data and 42.7 million or 14.4% of all people living in the USA were classified by the Census Bureau as Hispanic. That means 20.3% of the people classified by the Census Bureau as Hispanic were in the USA illegally.
One would expect from the data that people classified as Hispanic would have a much greater share of ER visits than their 14.4% share of the population, if Illegal Immigrants really had no access to health care coverage. But in fact people classified as Hispanic made up only 12.8% of all ER visits. So it seems Hispanic Illegal Immigrants are not being forced into the ER for treatment en masse.
It is Black Americans who have twice the rate of ER visits as their percentage of the USA population with 22.6% of the ER admittances versus 12.8% of our population. Yet people of African descent make up the lowest percentage of Illegal Immigrants at less that 3%. It seems Citizens out of work thanks to illegal immigration is where the real problem lies.
References:
www.cdc.gov/nchs/data/ad/ad372.pdf
pewhispanic.org/files/reports/61.pdf
www.census.gov/Press-Release/www/2006/nationalracetable3.pdf
Stephen on Sep 24, 2009 at 05:29:17 said:
Wow, I haven't read an article with such blatant BS as this one. Illegal aliens are bankrupting this nation. We are 10 TRILLION in debt and can't afford to support the poor and uneducated of the third world. We are being invaded by millions of foreign nationals. This is an act of war. Illegal aliens cost the US more than 350 BILLION annually in education, healthcare, social services and incarceration. More than 50,000 Americans have been killed or murdered by illegal aliens since 9/11/01. More than 200,000 sex crimes have been committed by illegal aliens against Americans. Thousands of them young children! If these criminal illegal aliens are so damn good for the nation, why is it 42 out of 50 states have a budget deficit. California alone spends 10 BILLION annually supporting illegal aliens. ENOUGH! Iraq or Afghanistan isn't as big a threat as Mexico. Bring home our military and secure our borders. Amnesty will be impossible to pass in this current political atmosphere. Americans are losing their jobs and homes. More than 35 million Americans go hungry daily. Mexico can't continue to be a parasite on the butt of the US. If Mexico is a de facto narco state, then we must act. An invasion and annexation of Mexico isn't out of the question. If we are going to absorb their population, we may as well have the land and resources too.
Stephen on Sep 24, 2009 at 05:15:00 said:
Wow, I haven't read an article with such blatant BS as this one. Illegal aliens are bankrupting this nation. We are 10 TRILLION in debt and can't afford to support the poor and uneducated of the third world. We are being invaded by millions of foreign nationals. This is an act of war. Illegal aliens cost the US more than 350 BILLION annually in education, healthcare, social services and incarceration. More than 50,000 Americans have been killed or murdered by illegal aliens since 9/11/01. More than 200,000 sex crimes have been committed by illegal aliens against Americans. Thousands of them young children! If these criminal illegal aliens are so damn good for the nation, why is it 42 out of 50 states have a budget deficit. California alone spends 10 BILLION annually supporting illegal aliens. ENOUGH! Iraq or Afghanistan isn't as big a threat as Mexico. Bring home our military and secure our borders. Amnesty will be impossible to pass in this current political atmosphere. Americans are losing their jobs and homes. More than 35 million Americans go hungry daily. Mexico can't continue to be a parasite on the butt of the US. If Mexico is a de facto narco state, then we must act. An invasion and annexation of Mexico isn't out of the question. If we are going to absorb their population, we may as well have the land and resources too.
nativessayno on Sep 23, 2009 at 22:37:16 said:
If these upstanding illegal immigrants already "pay" so many taxes; how is it they can send billions in remittances back home?
I beg to differ with your biased rhetoric; Reality is a VERY strong suit in this the matter. You propose we hand over what you say some deserve and want from us here regardless. We are saying: NO. Many may feel your grasp of reality is not your strong suit.
The objective reality is that healthcare reform and immigration reform are inter-related whether you acknowledge it or not.
Your "reality" premise is based on a person here working and paying taxes; but with whose documentation? Meaning your premise that all taxpayers should be included in the new plans.....except for the obvious fact that ID fraud is inherent in the "taxpayers" you cite. Ditto our social service programs...get fake papers and "go to town"! That is no fuzzy reality at all.
You conflate a "taxpayer" with a legal immigrant and a US citizen...that does not even make sense.
One can choose to not float in limbo and go back to their home countries. Cite some figures (billions) on what illegal immigrant healthcare costs US citizens annually; actual facts, not sentimental conjured notions. Billions. That is a bitter reality for citizens of the US! Or is that even material to your reality?
Nui on Sep 23, 2009 at 12:45:08 said:
Immigration reform is very very important to fixed, and should be the priority issue base to pass. Don't think about health insurance, it's not necessary to pass in this year.
Truth on Sep 23, 2009 at 11:48:09 said:
Immigration reform will only do GOOD for our nation.
The Undocumented immigrants paying more taxes than you think!! STOP THINKING LIKE A BRAINLESS PERSON CHECK OUT FACTS for yourself.
immigrationpolicy(DOT)org/
Eight million Undocumented immigrants pay Social Security, Medicare and income taxes. Denying public services to people who pay their taxes is an affront to America’s bedrock belief in fairness. But many “pull-up-the-drawbridge” politicians want to do just that when it comes to Undocumented immigrants.
The fact that Undocumented immigrants pay taxes at all will come as news to many Americans. A stunning two thirds of Undocumented immigrants pay Medicare, Social Security and personal income taxes.
Yet, nativists like Congressman Tom Tancredo, R-Colo., have popularized the notion that illegal aliens are a colossal drain on the nation’s hospitals, schools and welfare programs — consuming services that they don’t pay for.
In reality, the 1996 welfare reform bill disqualified Undocumented immigrants from nearly all means tested government programs including food stamps, housing assistance, Medicaid and Medicare-funded hospitalization.
The only services that illegals can still get are emergency medical care and K-12 education. Nevertheless, Tancredo and his ilk pushed a bill through the House criminalizing all aid to illegal aliens — even private acts of charity by priests, nurses and social workers.
Potentially, any soup kitchen that offers so much as a free lunch to an illegal could face up to five years in prison and seizure of assets. The Senate bill that recently collapsed would have tempered these draconian measures against private aid.
But no one — Democrat or Republican — seems to oppose the idea of withholding public services. Earlier this year, Congress passed a law that requires everyone who gets Medicaid — the government-funded health care program for the poor — to offer proof of U.S. citizenship so we can avoid “theft of these benefits by illegal aliens,” as Rep. Charlie Norwood, R-Ga., puts it. But, immigrants aren’t flocking to the United States to mooch off the government.
According to a study by the Urban Institute, the 1996 welfare reform effort dramatically reduced the use of welfare by undocumented immigrant households, exactly as intended. And another vital thing happened in 1996: the Internal Revenue Service began issuing identification numbers to enable illegal immigrants who don’t have Social Security numbers to file taxes.
One might have imagined that those fearing deportation or confronting the prospect of paying for their safety net through their own meager wages would take a pass on the IRS’ scheme. Not so. Close to 8 million of the 12 million or so illegal aliens in the country today file personal income taxes using these numbers, contributing billions to federal coffers.
No doubt they hope that this will one day help them acquire legal status — a plaintive expression of their desire to play by the rules and come out of the shadows. What’s more, aliens who are not self-employed have Social Security and Medicare taxes automatically withheld from their paychecks.
Since undocumented workers have only fake numbers, they’ll never be able to collect the benefits these taxes are meant to pay for. Last year, the revenues from these fake numbers — that the Social Security administration stashes in the “earnings suspense file” — added up to 10 percent of the Social Security surplus.
The file is growing, on average, by more than $50 billion a year. Beyond federal taxes, all illegals automatically pay state sales taxes that contribute toward the upkeep of public facilities such as roads that they use, and property taxes through their rent that contribute toward the schooling of their children.
The non-partisan National Research Council found that when the taxes paid by the children of low-skilled immigrant families — most of whom are illegal — are factored in, they contribute on average $80,000 more to federal coffers than they consume. Yes, many illegal migrants impose a strain on border communities on whose doorstep they first arrive, broke and unemployed.
To solve this problem equitably, these communities ought to receive the surplus taxes that federal government collects from immigrants. But the real reason border communities are strained is the lack of a guest worker program.
Such a program would match willing workers with willing employers in advance so that they wouldn’t be stuck for long periods where they disembark while searching for jobs. The cost of undocumented aliens is an issue that immigrant bashers have created to whip up indignation against people they don’t want here in the first place.
With the Senate having just returned from yet another vacation and promising to revisit the stalled immigration bill, politicians ought to set the record straight: Illegals are not milking the government. If anything, it is the other way around.
The Undocumented Immigrants pay the exact same amount of taxes like you and me when they buy Things, rent a house, fill up gas, drink a beer or wine, buy appliances, play the states lottery and mega millions . Below are the links to just a few sites that will show you exactly how much tax you or the Undocumented Immigrant pays , so you see they are NOT FREELOADERS, THEY PAY TAXES AND TOLLS Exactly the same as you, Now if you take out 10% from your states /city Budget what will your city/state look like financially ?
Stop your folly thinking , you are wise USE YOUR WISDOM to see the reality. They pay more taxes than you think, Including FEDERAL INCOME TAX using a ITN Number that is given to them by the IRS, Social Security Taxes and State taxes that are withheld form their paychecks automatically.
GAS Taxes paid by you & the Undocumented are the same. Go to and check out your states tax;
Cigarette Taxes paid by you & the Undocumented are the same,
Food Taxes, paid by You & the Undocumented are the same in each state check your state
Clothing Sales Taxes, are the same paid by you & the Undocumented Immigrant;
City Taxes, are the same paid by you or the Undocumented, since he pays rent and the LANDLORD pays the city :
Beer Taxes, are the same paid by you or the Undocumented:
Dave A on Sep 23, 2009 at 11:15:34 said:
"Our current systems of public health insurance (Medicare and Medicaid) already do a very, very good job of excluding ineligible immigrants."
-->This is a lfat-out lie. Ask anyone who works in a hospital and they will tell you the truth.