About "Illegal Immigrants"

By John Ballard

I despise the term illegal immigrant and hesitate to substitute undocumented alien because it is so damn prissy. Both terms are an attempt to sanitize one of Americas most pressing social and political challenges, a vast population of real people making invaluable contributions to our national life, both public and private. If they all vanished at once the impact on the country would be more catastrophic than The Rapture.

One line of last night's speech drew an uncivil "You lie!"

There are also those who claim that our reform efforts would insure illegal immigrants. This, too, is false. The reforms -- the reforms I'm proposing would not apply to those who are here illegally.

Nathan Cortez, writing at The Health Care Blog, makes a few points regarding not only the lack of medical care for immigrants generally but the despicable way they are sometimes treated when sick or injured.

This controversy should remind us that immigrants remain in a sort of health care purgatory, caught in our two most dysfunctional systems � immigration and health care. In the mid-1990s, Congress severely limited immigrant access to programs like Medicaid as part of welfare reform, making it difficult for even lawful immigrants to enroll. In fact, even lawful immigrants aren�t eligible for Medicaid for five years after entering the United States � and various peculiarities of immigration law often push this waiting period to ten years. At the same time, immigrants do receive indirect federal funding for health care through the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals with emergency departments to screen and at least stabilize patients presenting with emergent conditions. Thus, hospitals must provide emergency care regardless of the patient�s immigration status.

Unfortunately, most immigrants are ineligible for means-tested public insurance programs like Medicaid. This regulatory framework has led to �medical repatriation,� in which hospitals effectively deport immigrant patients to unload expensive long-term care burdens. Of course, hospitals � most of which are run by state and local governments � complain about unfunded federal mandates like EMTALA. Hospitals can be �stuck� treating immigrants whose medical needs have shifted from acute to long-term (as with the car accident victim who needs neurological rehabilitation and nursing care). As Prof. Boozang discussed, a growing number have begun �repatriating� immigrant patients by sending them back to their country of origin � without consulting immigration officials � sometimes by purchasing commercial plane tickets or even hiring air ambulances.

Certainly, there are more humane ways to handle health care for immigrants. California, for example, legalized cross-border health insurance, thus allowing immigrants living in the state to purchase insurance with lower premiums and deductibles that covers care provided in Mexico. Arizona and Texas have considered similar legislation, to no avail. Recently, UCLA researchers estimated that over 950,000 people travel from California to Mexico for medical care every year. For a population being left out of health care reform, traveling to Mexico for care may be the future � whether voluntary or not.

This is the first I have heard of the practice of "repatriating" someone due to a medical problem. I'm not surprised, but I find the idea reprehensible, an appalling betrayal of what America stands for. It makes a mockery of those lines of Emma Lazarus on the Statue of Liberty.

The New Colossus

Not like the brazen giant of Greek fame,

With conquering limbs astride from land to land;

Here at our sea-washed, sunset gates shall stand

A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name

Mother of Exiles. From her beacon-hand

Glows world-wide welcome; her mild eyes command

The air-bridged harbor that twin cities frame.

"Keep, ancient lands, your storied pomp!" cries she

With silent lips. "Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!"


�Emma Lazarus, 1883