And Now For Another Political Football In The Culture Wars

The Truth About Immigrants and Health Care

Bishop of Salt Lake City John Wester, PoliticsDaily.com 12/04/09

Representative Joe Wilson's now infamous "you lie" shout out to President Obama during his health care speech to Congress was featured in the press as an unprecedented breach of protocol.

Much less has been reported about the subject of the rant: keeping undocumented persons from accessing health care. (Part of this lack of reporting is because your fellow bishops kept everyone focused on removing constitutional rights from gays.)

With the passage of health care legislation, a majority of the House of Representatives shouted back. The House bill permits undocumented persons to use their own money to purchase coverage in the new health care exchange. (It will also ultimately prevent women using their own money to procure therapeutic abortions.)

This is contrary to the stated positions of not only Rep. Wilson, but also the U.S. Senate and the Obama administration. A closer examination of the merits of the House position should convince them that, in this case, sound public policy should trump divisive politics. (Which means unsound and discriminatory policies can trump divisive politics in other areas?)

With 12 million undocumented persons in the country, someone is going to need a doctor. While close to 4 million already have health care through employer-based plans, millions of others are dependent upon community clinics, emergency rooms, and the generosity of medical personnel who believe health care is a human right, not a privilege.

Although uninsured immigrants use emergency rooms much less than U.S. citizens, the cost of their care ultimately falls upon American taxpayers, either through higher insurance rates or tax money paid directly to providers. Permitting the undocumented to use their own money to purchase coverage would help alleviate some of this fiscal and financial burden on Americans.

It also would help Americans afford their own coverage. A study by the Kaiser Foundation concluded that immigrants are younger and healthier than average Americans and are less likely to access health care and drive up costs, keeping prices lower for everyone. By letting the undocumented buy into the exchange, the risks and costs of the new health care system would be spread out among more participants.

Given a chance, they will participate. The reality is that undocumented immigrants want to pay their way, as they do with taxes, Social Security payments, and health care contributions. Why not let them? A recent study found that 84 percent of undocumented Mexican immigrants in California offered employer-based coverage accepted it and paid for a portion of the costs.

Even for legal immigrants, Congress has yet to write the right prescription. Both the Senate and House bills fail to lift the ban, imposed in the welfare reform legislation of 1996, which prevents working but poor legal immigrants from enrolling in Medicaid for five years. Legal immigrants, who are on a path to become U.S. citizens, should be eligible for programs for which they pay taxes. (Unless they happen to be gay.)

Including immigrants in health care reform would help make health care affordable to all and make us a healthier nation. It also would make coverage accessible to the most vulnerable among us. Is that not the point of health care reform? To their credit, a majority of the U.S. House of Representatives thinks so.

In the end, the debate over immigrants and health care is really a debate about another affliction ailing our nation: the broken U.S. immigration system. In truth, without a legalization program and other reforms, our elected officials will continue to be faced with policy choices that treat U.S. citizens and immigrants differently but weaken the nation as a whole. (Just like we currently do our legal gay citizens.)

President Obama and Congress would be wise to include immigrants in health care reform and then enact immigration reform legislation, so that we are finally rid of the vitriolic immigration debates which have sullied our public discourse and confused our public policy decisions. (Too many of your fellow bishops would prefer to keep our discourse sullied and confused with abortion and gay rights effectively silencing your voice on the plight of illegal immigrants. Suppose there's a connection there?)

Until that time, breaches of protocol and political gamesmanship may continue to define the issue of immigration, to the detriment of all Americans. And immigrants could be left standing in the waiting room, asking for a doctor's appointment that may never come.

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Bishop Welsh has written a cogent argument for extending health care benefits to illegal aliens. Unfortunately for him his pleas sound hollow precisely because most of his positive arguments are used to deny rights to gay tax paying citizens and his fellow bishops are first in line in espousing these arguments. I've written before that the argumentation used to take away rights from gays would come back and rebound in the battle for immigration reform.

The USCCB has already agreed that it is permissible to tax people for programs and benefits they can't access. In fact, it is in the interests of the common good to do so. The USCCB has already agreed it is perfectly permissible to make it impossible for one to use one's own money to purchase legal forms of health care. In fact, it is in the interests of the common good to do so. In both these cases the USCCB advocated these situations as perfectly logical for legal American citizens. Now they seem to want to advocate exactly the opposite arguments for people illegally in this country. No wonder these arguments ring hollow.

Neo cons and their beloved tea baggers will point out that the Church which stands to gain the most from advocating for illegal aliens and health care is Roman Catholicism. Including illegals in health care reform benefits the Catholic health care system and the diocesan coffers of bishops like Welsh who have a significant illegal Hispanic population with in their dioceses. There is nothing the USCCB can use to refute these practical observations except to refer to the social justice mandates in the Gospels. Those very same arguments they won't use in issues of gay rights.

The really sad thing for me is these same bishops have banked on the cultural conservatism of the Hispanic community to roll back gay rights. Now this same Hispanic community will find out how frustrating and demeaning it is to be on the other side of culture wars. They will find out that the only people who are supposed to win in the culture wars are straight men who subscribe to white European patriarchal notions of a moral culture controlled by a cadre of elite males.

I hope many of them have crossed our borders out of the hope that the reality of dominance by an elite cadre doesn't apply in America, as it most certainly does in their home countries. I hope they can see through the rhetoric that told them gay rights was the 'agenda of an elite group of gays' and come to understand that the real agenda is about 'an elite group of mostly men' who are perfectly capable of attacking the very same groups they once patted on the back when that once courted group is now determined to be a threat to their wealth and power.

American Catholic Bishops will advocate for immigration reform because immigrants from the South increase their own portion of the wealth and power pie. It will be most interesting to watch previous tight culture war allies draw swords against each other over immigration. The outcome may not be what they expect. The sheep they fight over may just have their own ideas about where their allegiance lies. It may not include either the Church notion of rule by the clerical elite nor the secular notion of rule by the wealthy political elite. Because the truth is they can't trust either to use them for much more than political footballs--just like gays have learned.