Excluding Legal Immigrants From Health-Care Reform.

Last week, Mike Lillis caught a remarkable scene during the Senate Finance Committee debate: Republicans attempting to insert amendments that would bar legal immigrants -- you caught that, legal immigrants -- from accessing health-care exchanges, leaving those very immigrants Republicans say they are not hostile to, those who have "played by the rules" so to speak, without access to a reformed health-care system.

The rationale is that there is already a five-year waiting period during which new green card recipients are ineligible for Medicaid. The amendment was proposed by Sen. Jon Kyl, whom you might remember as someone who disagrees with the Reagan-era law mandating emergency room care for undocumented immigrants. That would essentially make being in the country illegally a death sentence for someone who gets seriously ill. Kyl also memorably tried to prevent the federal government from requiring insurance companies to offer maternity care, because he himself "didn't need it."

The Migration Policy Institute has a new report out today that sheds light on what the potential consequences would be of locking both undocumented immigrants and lawful permanent residents out of a reformed health-care system -- basically, it would cost more for all of us:

Exclusion of LPRs--as well as unauthorized immigrants--from health insurance reform would leave large populations still dependent on emergency rooms, community health centers, and other public health facilities, and would discourage early detection and treatment of chronic conditions. Thus, some of the short-term cost savings from excluding some immigrants from health care reform would be lost through cost shifting to state and local providers. Ultimately taxpayers and health care consumers would have to pay for uncompensated care for uninsured immigrants as well as higher health care costs in the future.

Already the proposed reform didn't cover unauthorized immigrants, but Democrats caved under pressure and changed the bill so that they couldn't even buy private insurance. (Maybe they should make it illegal for unauthorized immigrants to buy food? We can have cashiers check your papers at the grocery store! Freedom!) From the point of view of saving money, refusing to cover unauthorized immigrants already levees significant costs. Refusing to cover legal residents would be even worse.

There's obviously substantial political pressure not to cover unauthorized immigrants. But attempting to exclude those who didn't come here or stay here illegally? That requires a kind of reckless cruelty I find pretty astonishing, especially since it's one of the things some conservatives think is worth spending taxpayer money on.

-- A. Serwer

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