Research Paper on "Illegal Immigrants in the Healthcare USA"

Research Paper 6 pages (2313 words) Sources: 5

[EXCERPT] . . . .

Illegal Immigrant and the Healthcare

Illegal immigration has been at the center of on going debate for a long duration now and still is in existence. The argument is on whether these illegal immigrants are entitled to some form of health cover in the United States especially on the part of health reform and immigration reform. This is a dilemma particularly taking into account that the healthcare system, in the spirit of upholding the sanctity of the constitution, is formatted to take care of all those within the American border. Some arguments have it that the United States has a moral obligation to provide healthcare to everyone within its borders that is in need of such assistance. Others hold the argument that those who are illegally present in this country are not supposed to be entitled to take advantage of public benefits. There has not been a reliable way forward concerning the issue since both sides always try to justify their stand.

Even though the United States provide protection to individuals who are within their borders without considering legal status, such protection tends to be limited and they do not match those offered to the American citizens. As much as illegal immigrants do not have right or status to reside in the United States, they are not fully outside the legal and constitutional protection. But still they do not enjoy the same rights as the lawful immigrants or the citizens.

Based on the prevailing constitutional norms, illegal immigrants are not legally entitled to public health benefits. For example under the Ontario health benefits program, illegal immigrants have been excluded from government benefits programs. For public insurance programs like the Medicaid one has to have a proof of citizenship or legal residency. Moreover, illegal immigrants face exclusion from the individual mandate requirement of the PPACA, which restrict individuals for any benefits in case the individual was not a citizen or a national or is an alien who is lawfully present in the United States.

As much as these illegal immigrants face general exclusions to some level they enjoy health care and services. Women and children no matter their legal status they have been given a certain procedures covered pursuant to Medicaid, and this applies to many of the rest of the states. On top of these explicit provision of health care to illegal immigrants, according to the Emergency Medical Treatment and Active Labor Act, every hospital that receive Medicaid funds should screen and stabilize patients that approach them on emergency condition. This Act also gives mandate that treatment should be provided regardless of this individuals having the ability to pay, their legal status in the United States and whether they have insurance or not. Therefore, even though immigrants lack general public health insurance or coverage opportunities, they still have potential to receive necessary treatment, (Leighton Ku & Sheetal Matani, 2001). This has been affirmed by the study of emergency Medicaid spending within North Carolina, from 2001 through 2004. Its estimation was that 99% of the funds reimbursed were for treatment as well as services that were rendered to illegal immigrants.

However this has continued to limit the ability of illegal immigrants in the United States to enjoy medical benefits and services pass constitutional muster. Based on the rationale of the decision of the Supreme Court in the case of "Matthews v. Diaz." On the part of 'Diaz' the argument was that for one to qualify for Medicaid benefits, whoever is a non-citizen has to be admitted lawfully to the United States and has been a continuous resident for five years from the year of application for the benefits. According to a three-judge panel of the district court, the continuous residency requirement was unconstitutional and non-severable from the requirement of a person becoming lawfully admitted to the United States. The Supreme Court gave a ruling that these conditions were constitutional. Based on the main frame where the decision of the court came from still it applies today, in that, the constitution does not give opportunity for same treatment for every individual in the United States, alien or citizen, or the same treatment across different classes of aliens, (Richard Wolf, 2008). As it is quoted "a legitimate distinction between citizens and aliens may justify attributes and benefits for one class not accorded to the other; and the class of aliens is itself a heterogeneous multitude of persons with a wide-ranging variety of ties to this country."

This can as well be realized in the provisions of Congress in terms of welfare benefits for citizens where its preference is that the benefit not be provided for all aliens. It is not easy to advance a colorable constitutional claim, be it the resident diplomat, overnight visitors, or illegal entrant, to be fully part of the bounty that a conscientious sovereign makes available to its citizens as well as some of its guests. The court still found nothing irrational with this dictation by the Congress that access to public benefits by the aliens within the United States is to depend on the nature and duration of this person's presence in the country. According to court, the claim of the respondent-aliens was considered that Congress could have drawn a more reasonable line that was to make the aliens be part of the eligibility criteria; however, a revision on that issue was the one the Court felt ill-disposed to make. This decision is still applicable within the Medicaid as well as other related sectors.

Since there is no law that gives opportunity for the extension of public health benefits to illegal immigrants, denying illegal immigrants from coverage that are enjoyed by the citizens as well as lawful residents, tends to be rational and recognizes the necessity for line-drawing in developing public programs. Nevertheless, the requirement limits of law are never the same with the limits of what could be permitted by the policy. As per the United States Constitution which has no provision that mandate extension of public coverage to illegal immigrants, however in terms of policy nothing forbids them to do so.

In terms of health reforms as a general, what specifically determines the extension of some kind of coverage to illegal immigrants has to be as well cognizant of the dual dimensions of any proposed or existing health care. This is evident in the statement of pillars of health care and public health," health care is concerned with the health and well-being of population." When coverage has been extended to illegal immigrants there will be increase in accessing quality care, yet it will as well pose effects of decreasing costs of that care for the entire persons within the system, as it lowers the expenditures of emergencies, (Marc L. Berk, et al., 2000). Such coverage will additionally create carry-over benefits within the public health realm, for it be as a preventative regime as compared to giving space for progression of illness to more advanced points.

Including illegal immigrants in the fold of the official United States health care system, in terms of giving them opportunity to come in the bounds of Medicaid or providing subsidies by which private insurance could be purchased, might lower most of these costs significantly. As argued by Orszag that projection from the CBO hold that by adding cost of covering more millions Americans will initially be more than the cost reductions that is included within the legislation, however at some points the pattern will be reversed,(Dana P. Goldman, et al., 2006). Similarly, by adding illegal immigrants (additional costs at some points in the system) will save money on a system wide basis. This can be made possible in two ways: The first one is through including illegal immigrants within the pool of those who are insured thus spreading cost more broadly across the system, particularly whenever immigrants seek fewer health services. The second one is through encouragement towards insurance coverage which can be either private or public; this will make the government save costs in other places such as in spending of emergency Medicaid as well as in paying for cheaper, preventive treatments prior to erupt of the chronic issues that may arise. (Lawrence O. Gostin, 2008). The mechanism that is used by the medical insurance is for the purpose of spreading the risk individuals across the population so that the entire population be in a position to afford medical care whenever one is in need. This idea of risk pool is majorly used in case there are enough healthy individuals who can keep the overall health care expenditures lower as compared to premium costs to make high cost individuals covered as well. Depending on the size of the population like when the population is bigger, there will be more predictable and stable premiums and this is facilitated by the high cost of a few tend to spread out across many.

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