The Case for Healthcare for Illegal Immigrants

Sens. Baucus and Conrad are considering re-writing parts of the health care bill in reaction to Rep. Joe Wilson's uncouth blurt that Obama's pants were on fire when he claimed healthcare reform would not cover illegal immigrants. And liberals. Are. Screaming. I don't know about the politics of this -- it's not as though Wilson's vote matters, or will change out of deference to Conrad's thoughtfulness -- but let's consider the economics. Do illegal immigrants receive some form of health care already? Yes. Would extending Medicaid and subsidies increase the number of illegal immigrants on health care? Probably. Does that cost taxpayers money? Of course. So what should we do about it? Unclear.

By "unclear," I mean I have no idea how this problem should be solved, short of immigration reform, which is at least a year away from getting a proper hearing in Washington. But what's equally unclear to me is where other smart bloggers stand on the issue. Ezra Klein writes:

"No illegal immigrants will benefit from the health care tax credits." It's not exactly ambiguous. And it wouldn't be considered ambiguous except that Baucus now appears to be going back and saying it was, in fact, ambiguous.

But the question of whether illegal immigrants will benefit from the health care bill is quite ambiguous. In fact, many liberals -- see here, here, here, here -- are demonstrably proud and protective of its ambiguity. It's pretty clear that many don't want provisions written into the bill that make explicit the president's claim that health care reform will not benefit illegal immigrants.

One the one hand, it's pretty easy to see objections to that idea that we should allow undocumented workers to free ride on health care. You don't want to offer incentives to people to come to this country illegally and use expensive services without paying their requisite taxes. That subverts existing immigration policy, increases the strain on already-strained resources and foolishly announces the US as a medical provider-of-last resort for the Western Hemisphere.

But it's difficult to find good alternatives. Requiring citizenship to buy insurance on the exchange could be an expensive bureaucratic burden that doesn't work anyway (it hasn't in Colorado), because IDs are easily forged. And flu season is a good reminder that denying health care to people living in America, legally or illegally, is a really good way to get more Americans sick and increase health care costs.

The most logical solution to me is -- and I'm sorry if it's disappointing -- Democrats should probably do nothing. After all, Republicans aren't going to vote for this bill anyway, so what exactly is the purpose of moderating its content? But that's the political answer. Economically, I'm still struggling with how to grapple with the health care for illegal immigrants issue short of: Wait until immigration reform.