Politics & Policy

The Costs of Amnesty

Who's got the bill?

Given that Democratic Leader Harry Reid has threatened to filibuster any immigration bill that does not include amnesty for illegal aliens, someone should ask him a basic question: What happens to state budgets when twelve million illegal aliens become eligible for Medicaid and food stamps?

Right now, illegal aliens are largely ineligible for a whole panoply of federal programs simply because of their immigration status.

As the Pew Hispanic Center reported last year: “[A]bout a quarter of all drywall and ceiling tile installers in the United States are unauthorized migrants, as are about a quarter of all meat and poultry workers and a quarter of all dishwashers.” Whatever the nobility of honest labor, hanging drywall and washing dishes has not exactly been the road to riches. Again, quoting from Pew:

The average family income in 2003 for unauthorized migrants in the country for less than ten years was $25,700, while those who had been in the country for a decade or more earned $29,900. In contrast, average family incomes were considerably higher for both legal immigrants ($47,800) and the native-born ($47,700).
To put those numbers in perspective, a family of four earning $19,350 would be considered to be on the poverty line in 2005, according to “Medicaid At-a-Glance 2005.”

There are lots of government programs meant to help the needy. There is even a website, www.benefits.gov, where folks can ensure they are not missing out on a dime of government aid, like Medicaid, food stamps, Head Start, “Low Income Energy Assistance,” “Summer Food Service,” and “Weatherization Assistance.”

Neither Congress nor the Bush administration seems to realize that when illegal aliens who earn low wages are transformed into guest-workers or recipients of amnesty who earn low wages, they will immediately become eligible for all these government programs.

The Medicaid program, meant to provide modest health insurance protection for the needy, has already begun to devour state budgets. “Medicaid,” former Virginia Governor Mark Warner told the National Governors Association last July, “could actually bankrupt every state in the country before 2020 unless we can get a handle on it.”

According to the Centers for Medicare and Medicaid Services:

More than 46.0 million persons received health care services through the Medicaid program in FY 2001 (the last year for which beneficiary data are available). In FY 2003, total outlays for the Medicaid program (Federal and State) were $278.3 billion … [E]xpenditures under Medicaid … are projected to reach $445 billion … by FY 2009.
During President Bush’s first term, Medicaid’s growth continued to skyrocket. House Democrats were boasting last year that there are now “58 million Americans who depend on Medicaid for basic health care services” (a 26 percent increase from 2001).

Given that both sides concede there are at least twelve million illegal aliens here in the United States eager to take advantage of any amnesty or guest-worker program, what impact will that have upon Medicaid? If all twelve million illegal aliens were added to the Medicaid rolls via an amnesty/guest-worker program, that would be another 21 percent increase for taxpayers to absorb.

This projected 21-percent increase in Medicaid costs is likely to be a low estimate, given that current medical-care utilization rates among illegal aliens are virtually nonexistent. A 2000 Health Affairs study, “Health Care Use Among Undocumented Illegal Immigrants,” sought to prove that illegal aliens were not coming to the United States for medical care. According to their report, a mere 2.5 percent of El Paso’s illegal aliens had participated in Medicaid in 1996-97. In Los Angeles, only one out of ten (9.8 percent) did so, while Fresno led the pack with a Medicaid-participation rate by “undocumented Latinos” of 25.5 percent.

Another force that would drive Medicaid costs skyward after any amnesty or guest-worker program is Clinton Executive Order 13166, which mandates vast and costly translation services must not only be provided to anyone who asks, but that outreach must be made to “underserved populations.” It is not enough to provide free medical care–hospitals must actively recruit people to accept it.

The Senate can (and should) seek to amend any amnesty/guest-worker program with a general declaration of ineligibility for government benefits. After all, the 1996 welfare-reform bill denied federal Medicaid funds to new legal immigrants for their first five years here, except for emergencies.

Even if the Senate acts, taxpayers dare not rest easy. The power of immigrant rights advocates–inflated by twelve million freshly amnestied illegal aliens and who knows how many guest-workers and their families–will immediately be put to use, seeking to undo any benefit ban. (Even now, 41 states have voluntarily chosen to grant Medicaid to legal immigrants after five years.) And all it will take is one activist judge to rule that any benefit ban is a violation of the Fourteenth amendment.

Senators must be candid about the costs of whatever plan they propose for dealing with illegal immigration. A roll-call vote on giving Medicaid benefits to former illegal aliens would be illuminating indeed.

Jim Boulet Jr. is the executive director of English First.


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