This year’s presidential campaign has produced some truly despicable proposals on the issue of immigration.
Take erstwhile Republican front-runner Donald Trump, who has vilified Latin American immigrants in particular. He has led the chorus of anti-immigrant vitriol with his screwball threats to expel 11 million immigrants and their families and to build a wall along the U.S./Mexican border, effectively punishing millions of innocent Americans -to-be.
Last Tuesday, candidate Trump suffered his first defeat, coming in second in the Iowa caucuses to Texas Senator Ted Cruz. Cruz, too, has taken extreme positions on immigration despite arguably benefitting from it personally.
Collectively, Trump and Cruz have probably done more to set back efforts to have a rational discussion on immigration than the entire field of candidates combined.
And here’s the larger danger in that. When the most strident voices on this issue command a national stage to belch their brand of hostility toward immigration —from developing nations specifically – it poisons the public debate on sensible policies that can improve the lives of hard-working immigrants who strive to provide for their families and stake a place in our society.
Closing the coverage gap left by the Affordable Care Act
Here in New York, we’re hard at work advancing the conversation about how the state can provide health coverage to all its residents regardless of immigration status. This is precisely the sort of conversation we need to be having. But it’s unlikely to get the sort of press that Cruz and Trump command. That’s why I am writing about it here and now.
In a report released this month entitled, “How New York Can Provide Health Coverage to its Uninsured Immigrant Residents,” the Community Service Society examined the costs, eligibility and coverage options related to providing cost-effective, affordable and high-quality health insurance to nearly half a million unauthorized immigrants living in New York who are presently uninsurable due to their immigration status.
Under auspices of the Affordable Care Act, more than two million New Yorkers have enrolled in affordable, quality health coverage -- many for the first time – through the New York State of Health Marketplace. Yet many unauthorized immigrants living and working in New York are left out of coverage. Despite the state’s expansive public insurance programs, as many as 457,000 unauthorized immigrants in this state are currently ineligible for coverage, the vast majority of whom live and work in New York City.
Lack of health coverage can become a nightmare for immigrant families. Not only does lack of insurance deter people from seeking care, leading to excess mortality and morbidity, health care bills from when individuals do seek care can spell financial ruin for entire families. The broader health care system is also affected because uncompensated care – when provided – is frequently paid for by taxes and cost shifting.
The three coverage options investigated in the CSS report would extend health insurance to 90,100 to 241,600 immigrant New Yorkers, at a cost ranging from $78 million to $462 million annually.
It’s important to note that funding even the most ambitious of these proposals would result in a less than one percent increase in the state’s health budget of roughly $65 billion. New York State is now saving $645 million a year by shifting New York’s lawful immigrants from Medicaid into the new Essential Plan according to State Division of Budget calculations. That savings could go toward covering New York’s remaining uninsured immigrant residents.
State lawmakers are not expected to act on these recommendations this year. But going forward, we certainly hope that they spark a dialogue on the merits of expanding the state’s health insurance system so that our most vulnerable residents are included.
Extending health care opportunities to immigrants makes economic sense, enhances the health of our communities, and is consistent with our long history as a national leader in immigrant access and coverage. It is also consistent with public values.
Despite the fear-mongering and anti-immigrant rhetoric, the majority of voters recognize that immigrants bring countless benefits to our state and to our nation. Just having the conversation at the policy level would be a strong repudiation of the racist and divisive pontifications we’ve heard from some presidential candidates, and a reminder of New York’s history as a leader on addressing the needs of its immigrant residents.