The Poorest Immigrants Subsidize Healthcare for Everyone Else

New America Media, Commentary, EunSook Lee, Posted: Nov 29, 2009

Would it be acceptable if we were to make medical care out of reach for any segment of our nation’s population? For the 15.5 million Asian Americans, Native Hawaiians, and Pacific Islanders? Or for the 44.3 million Latinos? Let’s hope not. But, as it stands, our growing acceptance is paving the road for health reform proposals that categorically exclude our nation’s immigrant population. We forget that when people like Lou Dobbs or Rep. Joe Wilson are enraged about “immigrants” they are talking largely about communities of color. Americans know it is wrong to discriminate based on immutable characteristics such as sex or race—but convincing them to protect the act of being an immigrant remains a challenge that cuts across social justice issues such as health reform.

The days are nearing when we may see the passage of major health reform legislation. We know that there are significant differences between the House and Senate bills on how immigrants are treated -- for example, in the House bill, undocumented immigrants are able to purchase health insurance with their own money in the exchange while they will be excluded from doing so in the Senate. There are also common problems with both bills: the continued ban on federal funding for legal immigrants in Medicaid who have had their status for less than five years.

Currently, legal immigrants, who work and pay taxes that contribute to our health care system will continue to be ineligible to receive federally-funded Medicaid services for five years. In this case, we are not talking about those who make at least 133 percent of federal poverty level and could access affordability credits like everyone else for purchasing insurance in the exchange. We are talking about immigrants with the lowest incomes. It is unreasonable and saddening that under the current health reform proposals, the people who really need it will not get it.

This August we saw indignant crowds who largely had health insurance opposing the ability for more Americans to be insured. The indignation should also be coming from immigrant communities. And it is rising now. In the last two weeks, more than 6,000 people from Washington State to Washington, D.C. signed petitions demanding that immigrants be treated fairly by repealing the five year waiting period and enabling undocumented immigrants to purchase insurance.

On Monday, November 23, hundreds of people in California and Washington, D.C. stood up for immigrants in health reform in two distinct actions to highlight the best and the worst that there is in the national debate concerning how we as Americans treat immigrants. The rally and vigil outside of Speaker Pelosi’s office, and the confrontation with Rep. Joe Wilson’s staff are actions that drew not only longtime health advocates, but also people who realized that this complicated health care issue is intimately about them and could result in the exclusion of their friends, families, and colleagues.

Communities across America are waking up to this realization and Congress needs to take notice. In San Francisco, a group of Chinese American tenants gathered over 1,000 signatures in just two days, for example. A strong and diverse coalition of local and national community organizations from health advocates to immigrant rights organizations to Asian American and Pacific Islander community groups came together, because the call for equity in health reform needs to be louder.

EunSook Lee is the Executive Director of the National Korean American Service & Education Consortium (NAKASEC). Read more at http://nakasec.org/blog.

Related Articles:

Health Care Reform's Missing Piece: Elder Care

Five Years is a Lifetime to Wait for Affordable Health Care

Hispanic Caucus Troubled by Health Provision on Undocumented Immigrants


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User Comments


Super Radish on Dec 23, 2009 at 13:30:19 said:

I'm worried that this comment log is losing the idea of what health reform is about. Instead you see how people get lost in the "who's in, who's out" argument. Let's look at what public health does -- it builds quality of life for everyone. One person's drinking water is the same for all, regardless of immigration status. So to with medical care, health insurance, and pretty much anything else that is pro-life.


Lara on Dec 09, 2009 at 04:48:52 said:

Legal immigrants are green card holders, these people are Legal in the USA. They can obtain Welfare and they can work here legally and they do pay taxes.And they are reconized as green card citizen.The only thing they can not do it VOTE as an American Citizen.

And Illegals has NO rights to anything, because they do not have a green card making them legal to be here and they are not american citizens and they can not VOTE period.

People who are pro illegals are trying to confuse the US population. There is a difference between the two.

Plus there are alot of American citizens who does not have health insurance and can not get on welfare.Why you ask ? Because they are the people between the GAP and it has nothing to do with racism. It has alot too do with the gap of how much you can make in order to get help with welfare.And not making enough to buy health insurance.

Now about the immigration laws. They are not broken. American citizens and green card holders did not break the laws of immigration. The ones who broke the LAWS are illigals and their supporters wants our goverment and citizens to change our laws so they can by pass our laws and not have to obtain a green card or take the American citizenship test and why because they believe they should get special treatments.

People who are against illegals obtaining anything.It has nothing to do with racism it has alot to do with abiding by the laws of USA.

And if some are trying to change our laws based on the The 14th amendment. It was drafted for citizenship of freed slaves, not illegal aliens and their children a century later.Our constitution does not give children of illegal aliens born here citizenship unless they are black slaves being repatriotated after the civil war during reconstruction.

This is the immigration law they often used and they think it should be changed?

I am not against immigrants coming to USA, just as long as they abide by the laws and recieve a green card the legal way.


nativessayno on Dec 03, 2009 at 16:23:36 said:

....When you say 'we citizens want it for ourselves' -- it comes off as quite selfish, racist and ignorant.

I happen to be a person of color-have been my whole life, ha.....

But this is not material to MY argument nd still does not get around the claim: The Poorest Immigrants Subsidize Healthcare for Everyone Else. It just doesn't.

What if I went to their country and made these same pleas to their officials...are they racist, ignorant and selfish to deny me?

Also, you presume that all people of color agree with you by lumping us together....It obviously doesn't work that way.

Is it your premise that the healthcare limits are being made because the non-legal are persons of color; or is it because they are not citizens and disqualified and are thus being restricted?

Oh, sorry too selfish, racist and ignorant? Or just pragmatic and putting fellow citizens first?


Julie B on Dec 03, 2009 at 15:46:46 said:

We could solve the heathcare issues and illegal immigration with a mandatory E-Verify systen that is enforced nationwide.

We would not have to deport any one. Once the magnet for illegal immigration is removed the illegal will self-deport.


jerseycityjoan on Dec 03, 2009 at 11:23:58 said:

H,

For the record, I am for health reform. I am neither Republican nor conservative. Actually I'd support that's goes much further than what we're going to get now.

I am in no way trying to say who can see a doctor, but I am worried about who will pay for it.

I can see why immigrants here would want their parents (and other family members) to come here but why should American taxpayers pay for their care? After all, we do not ask them to come, they ask us for permission to live here.

I suspect we have a difference in perspective that no amount of exchange will reconcile, but please do not think that I dislike anyone or am prejudiced. I am not.


E. on Dec 02, 2009 at 22:12:22 said:

@nativesayno:

Please see www.dropdobbs.com/a-history-of-hate/

Here are some more citations at your request, courtesy of moi and Google search:
www.immigrationpolicy.org/sites/default/files/docs/Taxpayers04-08.pdf

www.dmiblog.com/archives/2007/04/undocumented_immigrants_pay_ta.html
www.taxfoundation.org/blog/show/1424.html

www.washingtonpost.com/wp-dyn/content/article/2006/06/04/AR2006060400965.html

Before suggesting others are lying, I hope you check your own facts and do your own research in the future.

When you say 'we citizens want it for ourselves' -- it comes off as quite selfish, racist and ignorant. People without US citizenship status are largely people of color. When you don't want people without status to be unable to get treatment for injuries, you're shutting out people of color.

Besides the fact that noncitizens do pay and contribute to society through taxes and other means--I agree with Cole that healthcare is a human right. Cole's was a pretty thoughtful response to your comment. Even if you try to dismiss it as "semantical", I dare you to wonder why even a semantical argument is relevant. Cole's argument is that humanity includes people regardless of what papers describe them, and that these papers shouldn't preclude us from letting people live. Cole's definition of humanity is mine, too.


H on Dec 02, 2009 at 21:41:48 said:

@jerseycityjoan -- CORRECTED version:

The interest of American citizens is to support health reform that will focus on making the new health insurance marketplace will benefit all people, and not allow one group to be pitted against the other for what is a shared cost and resource.

Overall, health reform seeks better regulation of health insurance companies and reducing the abuses that hurt everyday working families and health professionals. The health reform bills also try to regulate wasteful spending on the part of healthcare networks.

Where is the fairness in you, Joan, deciding when someone else should be allowed to see a doctor or not? Legal immigrants are such defined because they have decided they want to live in America and make it a better place. The immigration laws are broken, outdated and do not account for how health insurance has grown exorbitantly out of control to the point where it is today. For example, how can we reasonably expect working families to sponsor the full freight of hospital expenses for others when businesses and individuals struggle to pay for it themselves? You miss the point of health reform when you ask us to segregate communities in how they get enter the medical system. I agree with Ms. Lee in that we need to better regulate industry practices to benefit everyone in America, so that going to the doctor doesn't have to be as expensive as it is.

Finally, many sons and daughters want to be near their aging parents in their old age, and family caretakers provide a lot of care and attention beyond what the medical system can afford. At the same time, all elders have the right to live independently and we should support this as much as we can. We have a lot to learn and gain from our elders – and it's wrong to imply they are simply burdens, regardless of immigration status. The arbitrary federal five-year bar was installed in the '90s alongside xenophobic, anti-immigrant hysteria.

Health care is a basic human need and right; 2009 is a time to encourage all families to seek appropriate medical care, and make sure that doctors and nurses can treat their patients equitably. It's time to stop demonizing people based on immigration status and make health reform work for everyone. We can start by undoing the federal five-year bar for legal immigrants in Medicaid.


H on Dec 02, 2009 at 21:41:48 said:

@jerseycityjoan -- CORRECTED version:

The interest of American citizens is to support health reform that will focus on making the new health insurance marketplace will benefit all people, and not allow one group to be pitted against the other for what is a shared cost and resource.

Overall, health reform seeks better regulation of health insurance companies and reducing the abuses that hurt everyday working families and health professionals. The health reform bills also try to regulate wasteful spending on the part of healthcare networks.

Where is the fairness in you, Joan, deciding when someone else should be allowed to see a doctor or not? Legal immigrants are such defined because they have decided they want to live in America and make it a better place. The immigration laws are broken, outdated and do not account for how health insurance has grown exorbitantly out of control to the point where it is today. For example, how can we reasonably expect working families to sponsor the full freight of hospital expenses for others when businesses and individuals struggle to pay for it themselves? You miss the point of health reform when you ask us to segregate communities in how they get enter the medical system. I agree with Ms. Lee in that we need to better regulate industry practices to benefit everyone in America, so that going to the doctor doesn't have to be as expensive as it is.

Finally, many sons and daughters want to be near their aging parents in their old age, and family caretakers provide a lot of care and attention beyond what the medical system can afford. At the same time, all elders have the right to live independently and we should support this as much as we can. We have a lot to learn and gain from our elders – and it's wrong to imply they are simply burdens, regardless of immigration status. The arbitrary federal five-year bar was installed in the '90s alongside xenophobic, anti-immigrant hysteria.

Health care is a basic human need and right; 2009 is a time to encourage all families to seek appropriate medical care, and make sure that doctors and nurses can treat their patients equitably. It's time to stop demonizing people based on immigration status and make health reform work for everyone. We can start by undoing the federal five-year bar for legal immigrants in Medicaid.


H on Dec 02, 2009 at 21:38:57 said:

@jerseycityjoan

The interest of American citizens is to support health reform that will focus on making the new health insurance marketplace will benefit all people, and not allow one group to be pitted against the other for what is a shared cost and resource.

Overall, health reform seeks better regulation of health insurance companies and reducing the abuses that hurt everyday working families and health professionals. The health reform bills also try to regulate wasteful spending on the part of healthcare networks.

Where is the fairness in you, Joan, deciding when someone else should be allowed to see a doctor or not? Legal immigrants are such defined because they have decided they want to live in America and make it a better place. The immigration laws are broken and account for how health insurance has grown exorbitantly out of control to the point where it is today. For example, how can we reasonably expect working families to sponsor the full freight of hospital expenses for others when businesses and individuals struggle to pay for it themselves? You miss the point of health reform when you ask us to segregate communities in how they get enter the medical system. I agree with Ms Lee in that we need to better regulate industry practices, so that going to the doctor doesn't have to be as expensive as it is.

Finally, many sons and daughters want to be near their aging parents in their old age and family caretakers provide a lot of care and attention beyond what the medical system can afford. At the same time, all elders have the right to live independently and we should support this as much as we can. We have a lot to learn and gain from our elders – and it's wrong to imply they are simply burdens, regardless of immigration status. The arbitrary federal five-year bar was installed in the '90s alongside xenophobic, anti-immigrant hysteria.

Health care is a basic human need and right; 2009 is a time to encourage all families to seek appropriate medical care, and make sure that doctors and nurses can treat their patients equitably. It's time to stop demonizing people based on immigration status and make health reform work for everyone. We can start by undoing the federal five-year bar for legal immigrants in Medicaid.


nativessayno on Dec 02, 2009 at 17:00:14 said:

Cole states: "The important point here is that the racist invective used by people like Lou Dobbs and Rep. Joe Wilson perpetuate racism against people of color as a whole—the US-born, native peoples (American Indian/Native American, Native Hawaiians and other Pacific Islanders), documented and undocumented immigrants alike."

Please cite racist invectives made by Dobbs or Wilson against a generic group such as people of color. Racist invectives, are you sure about that?

Also, an argument for: humanity...who could argue against someone's humanity? Yours is a semantical argument about a generality.

24 Billion dollar debts are not about a rhetorical debate about humanity....it is about paying for non-citizens; again-meaning they don't pay.

Please cite figures for me on the non-citizens that have, will, and do pay for their citizen-provided services. Again, when they don't pay for these things the citizens do pay and pay.

Racism and injuring one's humanity are not sanctioned or welcomed, but they are not material to citizens wanting their funding to be provided solely for ourselves. I think you reek of ignorance in an intention to join in the obfuscating.

The Poorest Immigrants Subsidize Healthcare for Everyone Else is patently intrue.


jerseycityjoan on Dec 02, 2009 at 09:06:27 said:

Corrected version of last comment:

H,

I am not opposed to making some exceptions in this policy, especially for legal immigrants who have been here working for a number of years. Actually depending on the costs, I would support allowing legal immigrants here on work visas to access Medicaid in say, two years instead of five years.

However, I don't think that's what the author calls asks for or what would be acceptable to the so-called immigration lobby. I believe they simply want the obligations of the family sponsorship laws removed and the financial burdens shifted to the taxpayer.

It turns out that you can sponsor family members if your earnings are only 125% of federal poverty level, so of course many sponsors are just sponsors in name only. They cannot fulfill their financial obligations to the immigrant family member in times of trouble; they can barely support themselves.

However, this five-year Medicaid policy was created in the 1990s because people were doing things like bringing their elderly parents over and signing them up immediately for public benefits like Medicaid and SSI. I am if the law were eliminated that people would go resume bringing relatives over and signing them up right away for things.

I try to be reasonable and compassionate, but it disturbs me when I see that the interests of noncitizens are put ahead of the interests of American citizens.


jerseycityjoan on Dec 02, 2009 at 09:04:06 said:

I am not opposed to making some exceptions in this policy, especially for legal immigrants who have been here working for a number of years. Actually depending on the costs, I would support allowing legal immigrants here on work visas to access Medicaid in say, two years instead of five years.

However, I don't think that's what the author calls asks for or what would be acceptable to the so-called immigration lobby. I believe they simply want the obligations of the family sponsorship laws removed and the financial burdens shifted to the taxpayer.

It turns out that you can sponsor family members if your earnings are only of federal poverty level, so of course many sponsors are just sponsors in name only. They cannot fulfill their financial obligations to the family member in times of trouble.

However, this five-year Medicaid policy was created in the 1990s because people were doing things like bringing their elderly parents over and signing them up immediately for public benefits like Medicaid and SSI. I am if the law were eliminated that people would go resume bringing relatives over and signing them up right away for things.

I try to be reasonable and compassionate, but it disturbs me when I see that the interests of noncitizens are put ahead of the interests of American citizens.


H on Dec 01, 2009 at 15:30:07 said:

@ jerseycityjoan

The point of programs such as Medicaid is that when people fall into hard economic times, they should not be turned away from seeking medical care because they can’t afford it. It’s hard enough for people to get coverage for themselves, much less for their family members. With the economy as it is, and unemployment so high, it’s time to be prudent and compassionate about how we can help families in America grow healthy and strong, rather than demonize people for their immigration status.


H on Dec 01, 2009 at 14:47:04 said:

@ jerseycityjoan

The point of programs such as Medicaid is that when people fall into hard economic times, they should not be turned away from seeking medical care because they can’t afford it. It’s hard enough for people to get coverage for themselves, much less for their family members. With the economy as it is, and unemployment so high, it’s time to be prudent and compassionate about how we can help families in America grow healthy and strong, rather than demonize people for their immigration status.


cole on Dec 01, 2009 at 14:42:23 said:

The author is not suggesting anything regarding the immigrant status of Native Hawaiians and other Pacific Islanders; in fact, the category AAPI (Asian American Pacific Islander) is a political term that encompasses both immigrants and US-born people who identify in any way with their Asian or Pacific Islander background. The important point here is that the racist invective used by people like Lou Dobbs and Rep. Joe Wilson perpetuate racism against people of color as a whole—the US-born, native peoples (American Indian/Native American, Native Hawaiians and other Pacific Islanders), documented and undocumented immigrants alike.

I think what the author is getting at is that divisions between illegal/legal immigrants actually harm the country as a whole. If every person can have access to health insurance and confidently seek medical care when they are sick, regardless of immigration status, then we would be healthier—physically and economically—as a whole. The House bill, which allows all people to purchase health insurance at full cost makes complete sense from an economic standpoint. Undocumented immigrants would pay into the insurance system without subsidies, thus widening the insurance pool for everyone and contributing financially to meet the collective cost of health care. What matters here is the health of America in its entirety; if a huge chunk of our population is left out of health reform, then the change you want to see cannot truly occur.

Ms. Lee states that legal immigrants “work and pay taxes that contribute to our health care system.” Beyond that, undocumented immigrants do pay taxes as well; the Social Security Administration has concluded that undocumented immigrants “account for a major portion” of the billions of dollars paid into the Social Security System. As of October 2006, the reported earnings of those workers who cannot receive social security benefits because of discrepancies with SSA records totaled $586 billion. Further still, undocumented workers also pay sales and property taxes—directly if they own and indirectly if they rent. The National Research Council concluded that immigrants pay on average $80,000 per capita more in taxes than they will use in government services over their lifetimes.
Lastly, the statement that “if they have beef they can take it up with their home country…” reeks of ignorance. The push and pull forces that cause people to immigrate are not isolated within borders of foreign countries. The US has a hand in all of this—think NAFTA, the World Bank, US military occupations, etc. Check the racism in your statement that suggests people with US citizenship status are more important than foreign nationals who have settled in this country and are making life better for themselves and others. This kind of talk detracts from the reality that health care is a human right, and regardless of status, we should all have access to it.


jerseycityjoan on Nov 30, 2009 at 13:25:17 said:

Most legal immigrants were sponsored by family members, who promised financial support for them.

Why is this not mentioned in the article?

Why should the U.S. provide immediate healthcare to immigrants when at this time, it does not promise healthcare to its own citizens? Their family members made a commitment, why should they not be expected to keep it?

I could understand exceptions if people come down with major diseases, but that's not what you are talking about. You are talking about the federal government paying for someone's relative who came recently.


J on Nov 30, 2009 at 10:43:17 said:

Immigrant rights are human rights.

Whether a newer immigrant discriminated for the first five years of their legal status, or an undocumented immigrant discriminated for the length of their time without papers, immigrants are hard working people, too.

The immigration system in America is broken. Because this is what we are working with, we must not only push for comprehensive immigration reform, but also for immigrant rights as a continuing body of work. Right now, the opportunity for humane treatment of immigrants in health reform. Sadly, the narrow thoughts of some are jeopardizing the rights of many.


J on Nov 30, 2009 at 10:26:20 said:

Immigrant rights are human rights.

Whether a newer immigrant discriminated for the first five years of their legal status, or an undocumented immigrant discriminated for the length of their time without papers, immigrants are hard working people, too.

The immigration system in America is broken. Because this is what we are working with, we must not only push for comprehensive immigration reform, but also for immigrant rights as a continuing body of work. Right now, the opportunity for humane treatment of immigrants in health reform. Sadly, the narrow thoughts of some are jeopardizing the rights of many.


Jsmith on Nov 30, 2009 at 08:15:40 said:

"our growing acceptance is paving the road for health reform proposals that categorically exclude our nation’s immigrant population."

That's a lie. Most of my family are immigrants and they are all covered. Well, that may be because they came here legally. What the (unconstitutional) health care bill excludes is ILLEGAL IMMIGRANTS. We owe them nothing and they should NOT be covered.


nativesayno on Nov 29, 2009 at 23:26:26 said:

The bricklayer in the picture is a legal immigrant and he subsidizes my health care? In which universe?

Thank you for your snide, personal, rebuke though. I have voted Democrat since 1972...right wing...great analysis. Explain the part about Native Hawaiians again...the article tries to convey the fact that immigrants are shouldering citizen's health care...and he is wrong; also legal immigrants are NOT paying for my health care either. Unless there is a new definition of "pay for".

The writer does not clearly explain anything...except to try to create rhetorical talking points for amnmesty....But to my main point, citizens are paying the crazy -high cost of social services to legal and non-legal immigrants. If as you and the author say: the legal immigrants are paying the highest burden of the collective cost of health care, please provide evidence of those facts.

The Poorest Immigrants Subsidize Healthcare for Everyone Else.....everyone else? And again, why throw Hawaiian Natives into the mix ...they are citizens; which means they are paying to subsidize immigrant health care too...It is not a cogent or clear argument in any way.


scott lamson on Nov 29, 2009 at 20:20:06 said:

Hey 'nativesayno' you didnt bother to read the article. The writer was asking if it would be acceptable IF a section of the US population SUCH AS Asians, Latinos etc... could not get affordable health care. Then the writer explains quite clearly that LEGAL immigrants who pay taxes like everybody else cannot get the benefits for 5 years. That IS subsidizing your right wing 'Know Nothing' *** and now you know.


nativessayno on Nov 29, 2009 at 18:54:27 said:

Explain to me how your argument encompasses Pacific Islanders; Native Hawaiians; legal immigrants and illegal immigrants. Native Hawaiians are Americans and technically considered Polynesian; not Asian....thus not immigrants in any way shape or form- except perhaps is a strange conflation in a very weak argument cited here.

California is 24 billion dollars in arrears (The state issues IOUs), mainly because we are providing services to persons (undocumented immigrants), essentially for free! Should we continue to do that, and if so; why? As in they are getting services...but don't pay for them...like that....not paying means free.

Your byline makes absolutely no sense. Poor immigrants have to pay for my healthcare? Give one example.

I think you have it backwards...I am paying for the "poor" immigrants "free" healthcare. If they don't pay....you think it is actually free?

Citizens don't willingly provide foreign nationals with their "free" health care now or ever. Its very simple.

I am fully aware that there is a large legal Asian and Latino population in the US -an obvious fact not directly related materially to illegal immigration matters. I am referring only to the foreign nationals here poor- or otherwise- that citizens DO NOT want to pay for. **Thus the bills are excluding them from US citizen's provisions-like it our not!

Indignant crowds of citizens and indignant crowds of foreign nationals are not equitable in consideration. If they have a beef they can take it up with their home country and leave us to address our own giant problems without their "help".


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