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Letting illegal immigrants buy into U.S. health plans

One key area in which the House health care bill is superior to the Senate version involves health care for illegal immigrants. No, that was not a typo: illegal immigrants. Neither the House nor the Senate version would pay for health care for those who are in the country illegally — although it could be argued that, to the extent they land in emergency rooms without health insurance, everyone ends up footing that bill. The question is whether those who are in the country illegally should be permitted to purchase, entirely with their own money, insurance policies available on the newly created exchanges. The House measure would permit such purchases. The Senate would not — and the White House has unfortunately come down on the Senate side.

The real solution to the problem of illegal immigration is, of course, comprehensive immigration reform. Until then, millions of people are and are going to remain in the country illegally: The Congressional Budget Office projects there will be about 14 million who are not elderly in 2019. Of those, according to the CBO, almost 60 percent, or 8 million, will be uninsured. If some are willing and able to purchase insurance through the exchanges — and the CBO estimates that a few million would — it makes no sense to bar them from doing so.

In fact, allowing such purchases would benefit everyone. First, the more the ranks of the uninsured are reduced, the less the burden on hospitals and other parts of the health care system to provide uncompensated care, the costs of which are passed on to other consumers in the form of higher prices and premiums. Second, illegal immigrants to this country tend to be relatively young and healthy. The more such individuals purchase insurance, the healthier — and less costly — the risk pool.

The supposed danger of opening the exchanges to illegal immigrants is that they will somehow obtain government subsidies for the insurance. How much of a danger that is depends on the separate question of whether the verification requirements for citizenship or legal status are adequate.

The Senate's approach, which would require proof of legal status to obtain insurance through the exchange even for those not seeking government subsidies, would impose an unnecessary layer of bureaucracy without any evident benefit.

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