President Donald Trump issued a “Proclamation” on Oct. 4 requiring many immigrants seeking a U.S. visa to prove they will have health insurance coverage within 30 days of entering the country.
While we are skeptical that such a requirement will save taxpayers a lot of money, it’s still the right thing to do.
The Proclamation notes that uncompensated care costs—the costs of treating the uninsured who cannot pay for their care—exceed $35 billion a year.
But that figure includes all the estimated 27.5 million uninsured, the large majority of whom are American citizens, not immigrants.
Kaiser estimates that about 25 percent of the uninsured (about 7 million people) are noncitizens—i.e., both documented and undocumented.
And the Proclamation rightly includes eight categories of immigrants who are, for various reasons, exempt from the insurance mandate.
In other words, the immigrant population subject to the Proclamation is relatively small.
So why impose the mandate? Because it sends a message: Coming to the U.S. is an opportunity to become a productive taxpayer, not a drain on taxpayers.
Critics of the new requirement claim they detect a whiff of hypocrisy, since conservatives opposed the health coverage mandate in the Affordable Care Act.
But while conservatives thought mandating coverage was bad policy, their primary objection was that it was unconstitutional.
Many Democrats dismissed the objection, pointing out that people are required to buy auto insurance. So conservatives had to explain that there is a difference between the U.S. Constitution and state constitutions. The Constitution does not enumerate such power to the federal government; but states are free to mandate health or auto coverage if they choose.
On the other hand, the Constitution does empower the federal government to handle immigration, so mandating immigrants have insurance coverage or sufficient assets is within federal power.
Finally, critics of the proclamation also complain that health insurance coverage will be too expensive for most immigrants, since they tend to have lower incomes and are not eligible for Obamacare’s taxpayer-provided subsidies.
That’s true, but then most Americans buying their own coverage can’t afford Obamacare’s overpriced policies without subsidies either.
The good news is the Proclamation allows immigrants to choose from a range of non-Obamacare-qualified health insurance options. At least they will have access to affordable coverage.
October 9, 2019