Are Dems Helping Trump by Promising Health Care to Illegals?

‘Probably a position that is not going to sit well with the mainstream of the electorate…’

Kamala Puts Biden on Defense for His Past Opposition to Busing 1

Pete Buttigieg/IMAGE: NBC News via YouTube

(Mark Z. Barabak and Noam Levey, Los Angeles Times) With a sharp left turn, Democrats are risking a backlash on an issue of raw emotional and political sensitivity: providing government With a sharp left turn, Democrats are risking a backlash on an issue of raw emotional and political sensitivity: providing government health care to millions of people in the country illegally.

Ten of the party’s nearly two dozen presidential candidates stood on a debate stage last month and, without hesitation, raised their hands pledging themselves to the policy shift. Most others in the field have also expressed their support.

“This is not about a handout,” said South Bend., Ind., Mayor Pete Buttigieg. “This is an insurance program. We do ourselves no favors by having 11 million undocumented people in our country be unable to access health care.”

The promise was consistent with the prevailing sentiment of the party’s liberal base. But some worry the candidates have staked themselves too far left, boosting President Trump’s reelection prospects.


“There’s the question of how you provide health care for citizens of the United States and how you provide health care for residents of the United States,” said Peter D. Hart, a longtime Democratic pollster, who sees an important distinction between the two.

“To make them equivalent is probably a position that is not going to sit well with the mainstream of the electorate,” Hart said.

Trump would certainly agree.

The Democratic contestants hadn’t even left the debate stage when he weighed in. “How about taking care of American Citizens first!?” Trump said on Twitter.

Days later, he elaborated. “We’re going to stop it,” he told reporters of the promise to expand coverage to undocumented migrants, “but we may need an election to stop it.”

The debate over government health care for those in the U.S. illegally has long vexed policymakers, marrying fiscal concerns with the tensions surrounding immigration, both legal and illegal, and the demographic changes remaking the face of the country.

In most states, undocumented immigrants are barred from government-subsidized health care programs, such as Medicaid, the federal program for the poor and disabled.

California is a notable exception. Since 2016, the state has provided Medicaid to children under 18 regardless of their immigration status. In its new budget, California goes even further by extending the program to low-income immigrants until they turn 26.

The move has been largely greeted with a shrug. A March survey by the nonpartisan Public Policy Institute of California found nearly two-thirds of those surveyed supported Medicaid coverage for young adults without legal status.

“We’ve gotten relatively little, if any, organized opposition,” said Anthony Wright, executive director of the left-leaning advocacy group Health Access. He said the political hurdles faced in covering all undocumented migrants stemmed more from fiscal arguments than philosophical concerns.

That accepting attitude, however, isn’t widely shared.

A CNN poll conducted after the Democratic debate found nearly 60% of those surveyed nationwide opposed government-provided health insurance for undocumented migrants. While liberal Democrats were strongly in favor, nearly two-thirds of independents were opposed, as were 61% of self-described moderates.

Those, not incidentally, are the swing voters who tend to decide close elections.

“Most Americans want to make sure that their candidate for president cares about what’s good for the whole country, not just what’s good for one subset of people,” said Lanae Erickson, a politics and policy analyst at Third Way, a center-left Washington think tank.

Trump has consistently used the immigration issue to portray Democrats as weak on border security and more concerned with immigrants than the country as a whole, Erickson said, and candidates “need to be careful they’re not making his job easier.”

In crafting the Affordable Care Act, Democrats were acutely sensitive to the fraught politics surrounding immigration and health care. To defuse opposition they included language barring undocumented immigrants from enrolling in insurance plans created by the law, even if they were able to pay the full cost.

When President Barack Obama pitched the Affordable Care Act to Congress, he assured lawmakers the landmark legislation would exclude millions of people in the country illegally.

“You lie!” hollered Republican Rep. Joe Wilson of South Carolina, a rejoinder that not only shredded protocol but underlined the emotionalism surrounding the issue.

Politics aside, advocates say there are practical reasons to extend health care coverage to every American, regardless of immigration status.

Hospitals are obliged by federal law to offer emergency treatment to anyone who comes through the door, whatever their immigration status or ability to pay. Historically, that has placed a substantial burden on many urban providers of last resort, such as L.A. County-USC Medical Center.

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Julian Castro / IMAGE: MSNBC via Youtube

“We already pay for the health care of undocumented immigrants,” Julian Castro, one of the Democratic presidential hopefuls, noted on ABC. “It’s called the emergency room.”

Beyond that fiscal reality, there are public safety considerations.

Many physicians, hospital officials and public health leaders say it makes little sense to deny coverage to undocumented immigrants, warning, for example, that infectious diseases may spread more quickly if people are discouraged from seeking medical care.

Yet even as Democrats push for greater access to coverage — through “Medicare for all” or marketplaces created under the Affordable Care Act — Trump has moved in the opposite direction.

Recently, the administration unveiled its so-called “public charge” regulation, which could deny green cards — a step toward citizenship — to immigrants who receive certain forms of government assistance, such as Medicaid.

That further concerns public health officials and medical leaders who see immigrant parents forgoing health insurance for their children — even if their offspring are U.S. citizens — for fear that seeking care could jeopardize their chances of securing a green card.

(Barabak reported from San Francisco and Levey from Washington. Times staff writer Melanie Mason contribution to this report.)

©2019 Los Angeles Times. Distributed by Tribune Content Agency, LLC.