Health reform and immigration: the truth

In their tireless efforts to kill health care reform, right-wingers have fanned fears that it would attract illegal aliens. This sideshow is rather twisted because, actually, the reforms would do the opposite. They would help curb illegal immigration.

Start with Canada to see how this works. Canadians have universal coverage, a big immigration program and almost no undocumented workers. These things are not unrelated. Government-guaranteed medical care is a big reason why Canada doesn’t tolerate illegal immigration. No country can long afford a large subclass of poor workers that pays little in taxes and collects full benefits.

To quote conservative economist Milton Friedman, “It’s just obvious that you can’t have free immigration and a welfare state.”

Here in the United States, the House health-reform bill has an entire section titled, “No Federal Payment for Undocumented Aliens.” Furthermore, it requires every worker to have coverage, while denying subsidies to illegal immigrants, whatever their income. In other words, illegal immigrants would have to obtain health insurance and pay full freight for it. That doesn’t sound like a five-course free lunch to me.

Aha, say Republican foes of the legislation. The illegals will get around it. “Without the verification, you can’t frankly believe it is serious,” says Rep. Lamar Smith, Republican of Texas. Fair point. Let’s address it.

As a practical matter, undocumented workers shy away from government programs that could expose their illegal status. A law passed in 2005 requires applicants to Medicaid, which insures poor people, to prove their citizenship. Two years later, the House Committee on Oversight and Government Reform studied Medicaid enrollments in five states (Kansas, Colorado, Minnesota, Washington and Wisconsin). It found only eight illegal immigrants on the rolls.

But, says Georgia Republican Rep. Phil Gingrey, “a lot of their kids are in the school system.” That’s true. The schools don’t check for immigration status. Medicaid does. And so would the health care system now envisioned by Congress.

It’s worth noting that President Obama’s is the first administration to seriously crack down on illegal immigration in decades. Under its orders, the Immigration and Customs Enforcement Agency has stepped up audits of companies suspected of using illegal labor. Hundreds of offenders have been slapped with stiff fines and warnings to mend their ways.

The administration has just started requiring any company seeking sizeable federal contracts to use the E-Verify system, a database containing Social Security and other records, to ensure that its workers are legal. (First it had to fight off a suit by the Chamber of Commerce and industry groups that use undocumented labor.)

Meanwhile, Chuck Schumer, the New York Democrat who heads the Senate Immigration Subcommittee, is promoting biometric tools to replace the use of documents that can be counterfeited or stolen. Biometrics rely on such unique identifiers as fingerprints and the iris of the eye.

We should examine what’s really behind the right’s argument that universal health coverage would draw more illegal immigrants. It’s an assumption that if you keep America’s low-wage workers miserable enough, undocumented foreigners won’t want to join them.

That’s neither nice nor good for the country. The dirty truth is that the uninsured are not people on welfare or very poor workers. Those groups get covered by Medicaid. The uninsured are mainly struggling families who make too much to qualify for Medicaid but not enough to afford the coverage — or those rejected by private insurers because of pre-existing medical conditions.

To sum it up, the Democrats’ policies are already reining in illegal immigration, and the proposed health care reform would, if anything, contain it further. Those trying to stop reform should look elsewhere for scare tactics.

Froma Harrop is a Providence Journal columnist. Her e-mail address is fharrop@projo.com.

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