Three Public Health Reasons to Pass Immigration Reform

I’ve highlighted previously how immigration restrictionists have seized upon the discussion about the energy-climate bill to promote anti-immigrant policies which rely on pseudo-green arguments.

You can bet they’ll do the same thing in the health care debate.  And opponents of progressive health care reform will do their best to doom an effective bill by connecting it to immigration.

In brief, the argument goes something like this:

We, the GOP and allies, have created a huge undocumented underclass through flawed immigration policies which we have pushed through Congress over the past 20 years in the face of a supine Democratic party which mostly feigns indifference to the issue.  We have opposed sensible immigration solutions at every turn, ensuring that this underclass remains in the shadows where it can be easily exploited by unscrupulous employers.  The existence of the underclass which we created and maintain serves as a useful scapegoat for every conceivable political issue, from national security to the economy to health care.  We love undocumented immigrants and hope they’ll stick around for years to come.

Unfortunately, raising the immigration issue outside the immediate context of immigration reform causes most left-leaning politicos to produce a dark and spreading stain down the front of their khakis.  That’s why I’m happy to see writers like Ezra Klein and Matt Yglesias tackle the issue, though I’d encourage them not to assume that immigration is too politically toxic to talk about outside the approved comprehensive reform framework.  Like the belief circa 2003 that it would be politically disastrous to oppose the Iraq invasion, this assumption is propped up by groupthink and misinformation, not by evidence.

Here are three public health reasons to pass inclusive, progressive immigration reform.

One: Failing to pass immigration reform hinders other reform efforts, including health care reform. Matt Yglesias:

It’s unfortunate that every substantial social policy argument we undertake now needs to have a “how are you going to exclude undocumented immigrants?” component. And not just unfortunate, to some extent it’s paralyzing. Suppose some zealot proposals a bill to revoke the federal transportation funding from any state that allows undocumented immigrants to ride on its mass transit systems? Next thing you know, bus drivers are checking people’s green cards and nothing works.

Two: Excluding undocumented workers from access to health care makes documented workers less competitive, putting pressure on employers to cut health benefits for documented workers. Ezra Klein:

If you're really worried about the native-born workforce, what you want to do is minimize the differences in labor costs between different types of workers. A health care policy that enlarges those differences -- that makes documented workers more expensive compared to undocumented workers -- is actually worse for the documented workers. But that's a hard argument to make politically. So we're likely to see a debate where politicians brag about helping American workers by excluding illegal immigrants from health reform even as what they're actually doing is making illegal immigrants more economically competitive against native workers.

Three: Excluding undocumented workers from health coverage is bad health policy for everyone.

Like hurricanes or acid rain, communicable diseases don’t discriminate based on immigration status.  It’s in the interest of the public at large to treat health problems before they end up in the emergency room, which is expensive, or before sickness spreads to others.  Furthermore, existing immigration laws specify processes for government-approved doctors to screen intending immigrants for communicable diseases.  Putting people on track to legal status would bring health problems to light and allow immigrants to get treatment, which is good for everyone else living in those communities.

To the restrictionist, the idea that an undocumented immigrant might receive health care through a government insurance program or that an untreated immigrant might cause someone else to get sick are both good reasons to simply deport them all.  A more reasonable perspective would acknowledge that these two rationales are contradictory, that you can’t deport 12 million people while maintaining liberal democracy as we know it, and that the issue can best be defused by providing an inclusive path to legal status for undocumented immigrants.

I don’t know why this is such a “politically explosive” argument to make, in the words of Yglesias and Senator Max Baucus.  It seems like common sense.  I hope that President Obama doesn’t permit his timidity on immigration reform to derail health care reform.