As it stands, the Senate immigration bill will leave many of the newly legalized between a rock and a hard place. Locked out of the parts of health reform that make health insurance more affordable, but subjected to the individual mandate — the requirement to have coverage or pay a fine. Not surprisingly, given the high costs of private coverage — and one of the reasons most Americans purchasing coverage in the new marketplaces will qualify for subsidies or tax credits — many of the newly legalized could go without coverage and opt to pay the fine.
This is bad public policy and bad fiscal policy.
While the initial cost of extending coverage to the newly legalized may be significant, the amount is an investment that is needed and cannot be avoided. Health costs will become due now or later. There is no getting around the need for any uninsured individual — regardless of immigration status — for basic health care. This need will not disappear regardless of the number of complex restrictions put forth.
Without affordable health insurance, health care is out of reach for most of the uninsured. The average hospital stay in the U.S. costs more than $15,000 and the average cost for a doctor’s visit is $89 — expenses that can, at worst, bankrupt a family; and at best, force tough decisions to be made.
The costs for uninsurance and access barriers are high, one of the reasons our health-care system is burdened and why health reform was so needed. The uninsured have less access to preventive care and have worse physical and mental health outcomes. Putting off the costs of treatment results in more expenses in the long run, expensive emergency room visits and needing to rely on already overburdened safety-net hospitals and overwhelmed clinics.
The price for this heath care system is huge, with 85 percent of the costs of uncompensated care falling on the government. And then there is the lost economic productivity and economic security. The human and economic toll of locking out millions from affordable coverage options could be astonishingly high. Especially, as the Pew Research Center reports, the majority of the undocumented population are young working families.
Healthy workers are productive workers. But unfortunately, lawmakers are attempting to kick the costs of health care down the road that will invariably lead to worse health outcomes and expenses for everyone.
Compromise is noble. But, is it really worth risking the health and well-being of the entire nation for short-term savings?
Huang is the policy director at the Asian & Pacific Islander American Health Forum, the nation's premier health advocacy organization for Asian Americans, Pacific Islanders and Native Hawaiians. Huang is also the author of "Anchor Babies, Over-Breeders, and the Population Bomb: The Reemergence of Nativism and Population Control in Anti-Immigrant Policies.”