Here’s a novel question: We are all struggling with a cumbersome and expensive health care industry, trying to find ways to fix a broken system for Americans. Why on earth would we invite the rest of the world to access our system for free?
That was essentially the question pro-sovereignty figures in the Trump administration asked before they pushed for the new rule announced Friday to bar admission of those immigrants who show up at our hospitals without insurance or any way to pay out of pocket.
Section 212(a)(4) of the Immigration and Nationality Act (INA) states that an individual seeking admission to the United States or seeking to adjust his status to permanent resident (obtaining a green card) is inadmissible if the individual “at the time of application for admission or adjustment of status, is likely at any time to become a public charge.” There is no greater public charge than someone coming here specifically to access our hospitals for immediate or long-term medical care without a means of paying for it. Either way, our doctors will always treat a patient seeking help, but the American taxpayer is stuck with the tab.
Therefore, the president issued a proclamation ordering that effective November 30, most immigrants seeking entry must be “covered by approved health insurance … within 30 days” of entry, or “possess … the financial resources to pay for reasonably foreseeable medical costs.” The criteria for what constitutes coverage are very loose. The applicant can hold any catastrophic plan or show the ability to pay out of pockets. This is not like an Obamacare mandate on immigrants; it’s simply to say that taxpayers must not be saddled with a substantial bill.
The order is yet another way of simply enforcing existing public charge laws that were supported by both parties throughout our history. It will not affect those who were already granted immigrant visas, only those seeking them after the effective date. It also exempts children of U.S. citizens seeking entry, children under 18 coming here alone, or parents of immigrants who are sponsored.
Of course, according to the Left, everything is about race. “While Trump wants to use health care as a weapon to advance a racist and xenophobic agenda, we are going to guarantee health care to all and we’re going to win,” whined Bernie Sanders in a tweet Saturday morning.
Now, almost every Democrat candidate supports taxpayer-subsidized health care and insurance for illegal aliens too. As conservative health care expert Chris Jacobs observed, just last generation, none other than Hillary Clinton opposed offering free health care coverage to illegal aliens because “we do not want to do anything to encourage more illegal immigration into this country.” She noted in her testimony before Congress in 1993 that “too many people come in for medical care, as it is. We certainly don’t want them having the same benefits that American citizens are entitled to have.”
This sentiment was expressed in the text of the welfare reform legislation of 1996, the Personal Responsibility and Work Opportunity Act of 1996 (PRWOA), which was signed into law by her husband: “It is a compelling government interest to remove the incentive for illegal immigration provided by the availability of public benefits.”
The Trump administration would be wise to disseminate the clip of Hillary widely and expand the health care proclamation to the most obvious culprits: illegal immigrants. While this order targets those seeking free health care through the visa system, why should those who crash our border we any better off?
Yet over the past year, thousands upon thousands have come to our border for the express purpose of seeking health care. The American people have the right to know how much is being spent on health care for illegal aliens at our border. Agents have taken 21,000 sick or injured illegal aliens to the hospital from January through July, consuming 250,000 agent man-hours. What is the tab of that, and who is paying for it?
Using a formula from Steven Camarota of the Center for Immigration Studies (CIS), it’s estimated that the lifetime cost of just this year’s flow of illegal immigrants could easily top $150 billion.
But the health care costs are often immediate. Many of the illegal aliens who flooded the border came for expensive long-term medical treatments, not just triage for dehydration resulting from the perilous journey north.
In August, Todd Bensman, senior national security fellow for CIS, visited the border and was told by agents that many are coming for long-term treatments. “What they told me is that probably half to two-thirds of everyone that they apprehend those families, family units are going to the emergency room, into the hospital, are getting full treatment, from cardiovascular assessments, MRIs, and X-rays,” reported Bensman on my podcast at the time.
Ultimately, taxpayers are covering this through DHS’ budget with funds that should be used for homeland security and protecting Americans from all those who infiltrate and never get caught. I’ve also heard from border agents that, upon interviewing illegal aliens at the border, they found more of them coming for health care, especially pregnant women, but also those seeking long-term care for ailments such as AIDS. Astoundingly, some illegal aliens are now suing ICE because they don’t like the quality of the medical care!
Much of this will be ameliorated through the administration’s other reforms at the border, but still, there is no reason this public charge rule on health care shouldn’t apply just as rigorously to border-crashers. This new order invokes sections 212(f) and 215(a) of the INA, which give the president full authority to suspend or regulate any immigration of any sort to any place of entry when he deems it in the national interest. I’m glad the administration has finally discovered this authority, but the president should use it more broadly at the actual land border as well.
Our legal immigration and visa system is definitely broken, but nothing matches the fiscal cost of illegal immigration.
Daniel Horowitz is a senior editor of Conservative Review. Follow him on Twitter @RMConservative.