What’s Missing From the Health Care Bill

In the spring of 2010, President Barack Obama passed a momentous health care bill. Said bill dominated most of the political discourse during his first year; to date it constitutes one of the president’s most substantial achievements.

In dealing with the issue of health care, Democrats faced a choice of whether to concentrate on cutting costs or extending coverage to the uninsured. For better or worse they chose to focus on the latter. Due to this choice, the health care bill is estimated to extend health care insurance to 32 million out of a total 55 million uninsured people.

This leaves, however, some 23 million people who will not benefit from health care reform. Some of these individuals will opt-out of buying health insurance voluntarily; for instance, young people may decide to pay a fine rather than buy government-mandated health insurance.

There is, however, a substantial population – numbering something like six to eight million people – who were unilaterally denied the right to health care. These people are some of the most despised in the United States, living in constant fear and harassment. They are almost all poor, disadvantaged, and denied the opportunity to advance in American society. Even a straight-A college graduate belonging to this population is confined to menial labor.

The Obama administration has also been antagonistic with this group of people. Indeed, Mr. Obama’s health care bill explicitly prohibits undocumented immigrants from participating in the government programs it sets out. This is both terrible policy and naive politics.

Let’s start with the politics. The Obama administration decided not to include undocumented immigrants in order to win political support from Republicans – who are strongly opposed to undocumented immigration. If Democrats had included undocumented immigrants, Republicans would not have voted for the bill, and conservatives would not have supported health care reform.

Oh wait – that’s right, conservatives didn’t support the health care bill anyways, and not a single Republican voted for the final version. In fact, conservatives did absolutely everything they possibly could to oppose health care, whether it included undocumented immigrants or not. In effect, the Obama administration naively sacrificed one of the most abused groups in the United States to gain Republican support that did not exist in the first place.

That leaves the policy side of the equation – is insuring undocumented immigrants good policy? In fact, right now undocumented immigrants are insured; they are just done so in an extremely inefficient manner. This insurance is called the emergency room. There is little need to explain how using emergency room visits to treat undocumented immigrants causes soaring costs; immigrants without insurance delay treating illnesses until the last second, when things are far worse (and more expensive) than they otherwise would be. Then they cannot afford to pay, making costs go up for the hospital and therefore everybody else.

The solution is to provide health insurance to undocumented immigrants. This stops them from being a burden on government services – which ought to make conservatives happy – and lowers costs. It is also, by the way, the right thing to do. A shame that the Obama administration did not have the courage to do that.

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4 Responses to What’s Missing From the Health Care Bill

  1. s. polanco says:

    Illegal Immigrants are just that Illegal and there for need to become legal this is posable if they get an TPS there are cherities that can help with this ( Catholic Immigration Charities ). I would sugest that Illegal Immigrants do this because what Iv’e seen from my referances President Obama has deported more Illegal Immigrants in his first year in office sence President George Bush Jr.did after 9/11 this leads me to wonder if He is going to do any thing about Illegal Immigrants to help with healthcare in the future. It seems that the problems for Illegal Immigrants is just about to get worse.

    • inoljt says:

      Thanks for the comment!

      I’m not entirely sure what you’re saying, actually – but I don’t think it’s very possible for an undocumented immigrant to become legal right now.

  2. Jessica says:

    I agree that excluding undocumented immigrants from healthcare reform is terrible policy, but I think your analysis of why it was done is mistaken. The House version of the bill would have allowed undocumented immigrants to use the exchanges but without subsidies; banning them from the exchanges entirely was added to the Senate bill after some of the Democratic Senators from red states got spooked by the Joe Wilson “you lie” brouhaha. It’s conceivable that this was part of the price of getting the more conservative Dems in the Senate on board for cloture.

    • inoljt says:

      You definitely have a good point there. I hadn’t thought about excluding undocumented immigrants as part of a concession to conservative Democratic senators, rather than Republicans who weren’t going to vote for health care in the first place. The Senate version of health care was definitely more conservative than the House version, sometimes in good ways (e.g. the Cadillac tax) and sometimes in bad ways (like this). If that is true, although I’m not entirely sure it is, may be slightly more politically palatable.

      It’s still terrible policy though – something that makes health care more expensive and less humane, while at the same time forcing undocumented immigrants to “leech” off the government.

      Thanks for the comment.

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