When it comes to the question of illegal immigrants receiving health care, passions can run high. There are a lot of considerations. Basic humanity, as well as the hippocratic oath, requires doctors to treat patients in need of urgent or life-sustaining care. It doesn’t matter if they can pay for it or if they are in this country illegally. But, of course, you don’t want people coming to this country for the sole purpose of receiving emergency care (to have a baby, for example). Be that as it may, there are millions of undocumented people in this country. And just as we face a conundrum when dealing with undocumented people wanting to drive, we have to deal with the fact that they will get sick and need care. If they can afford to buy health insurance, they should not be barred from purchasing it. Whether or not U.S. taxpayers should provide subsidies for undocumented people who cannot afford health insurance is a more contentious matter. Wherever you come down on that issue morally, there can be no doubt that providing subsidies in these cases would be politically unpopular in the extreme.

If undocumented workers are subject to the mandate, as some of them appear to be in HR3200, that would present a bit of a problem. Why? Because, as Jed Lewison notes, Section 246 of HR 3200 provides:


Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

Congress is going to have to iron out their definitions to make sure that they don’t create a class of people who are mandated to get health insurance, but who are barred from receiving affordability credits. William Jacobson sees this as a problem, too.

It also would be interesting to see how long the exclusion of illegal aliens from getting the credits lasted, since as the CRS notes, illegal aliens are subject to the health care mandate; one can anticipate the argument that if the House Bill requires illegals to have qualified health insurance, some accomodation needs to be made for those who cannot afford it.

Absolutely. And since it is politically impossible to create direct subsidies for undocumented workers, the only solution is to exempt them from the mandate.

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