Senator Marco Rubio’s office recently posted a new video of him answering questions from constituents about immigration reform. He complimented one perspicacious question — regarding the fact that amnestied illegal immigrants are excluded from Obamacare, the constituent asked:
Might that have the unintended consequence of making them more desirable for employment than American citizens? . . . If I were an employer and did not have to hassle with health care if I employed a foreign worker, I would certainly give preference to them.
Rubio says the questioner “make[s] a very compelling argument for repealing Obamacare,” but doesn’t actually provide a satisfactory answer to the question — probably because there isn’t one. Rubio admits that’s how the legislation will work — the burdens put on employers by Obamacare in certain cases will sometimes not apply when they hire once-illegal immigrants — and just goes on to explain that this has to be “balanc[ed] against” “the problem that these people have violated the laws of the United States, our immigration laws, and it isn’t fair or right for them to be able to benefit from a government subsidy like Obamacare.” But this doesn’t in any way address the questioner’s concern, which is that legalizing these immigrants will make them more desirable for some companies to hire (ceteris paribus) than Americans.
Specifically, companies over a certain size that don’t and won’t provide insurance of the quality and cost Obamacare mandates — it looks like there will be a good number of them — have to pay a fine of up to $3,000 per employee per year. Amnestied immigrants won’t count, as the law will still consider them “not lawfully present.” There isn’t an easy solution: You could impose penalties on employers for uninsured provisionally legal immigrants, but this would increase the footprint of Obamacare and raise taxes in order to subsidize the exchanges for everyone else. The simple matter is that the bill as written, combined with our welfare state, would have a number of unavoidable unintended consequences, and proponents of the bill ought to be upfront about them.
Rubio’s other defense of how the bill deals with Obamacare, in fact, involves considerably more obfuscation. He explains that the Obamacare exclusion helps “make sure that people who are being legalized in this country can sustain themselves. The last thing we want to do is legalize 11 million people and have them be dependent on government.”
For one, obviously this measure does nothing to verify that illegal immigrants granted amnesty are capable of supporting themselves or not being net beneficiaries (in theory, there are some measures in the bill specifically to do so). People in the U.S. illegally are apparently just fine getting along without any benefits from Obamacare help — indeed, when they chose to come here, it probably hadn’t even been passed.
But further, if Rubio believes his own premises, there isn’t a good argument for excluding amnesty recipients from the law — either he believes the people we’re legalizing ”can sustain themselves,” as he claims, so they won’t be beneficiaries of means-tested programs anyway, or they can’t, meaning they have to be excluded from “a government subsidy like Obamacare” because he believes they don’t deserve the government benefits they’d be getting. This contradiction is partly true of all the means-tested benefits programs from which the Gang bill aims to exclude once-illegal immigrants, but it’s especially clear with Obamacare.
That’s because, if the majority of illegal immigrants, once legalized, aren’t likely to be net beneficiaries of Obamacare, it would actually be a lot better for native Americans the amnestied immigrants were counted as legal in the law (as opposed to other welfare programs, where it’d be a moot point). If once-illegal immigrants and their employers are exempt from the whole law, they can’t receive its benefits, but they can’t buy into the system to help it work (as best it can under Obamacare), either.
The questioner leaves out the fact that previously illegal immigrants are not going to be subject to the individual mandate. It seems likely most illegal immigrants, once legalized, given their low incomes, will maintain their current status — uninsured. That’s even before one considers the fact that those “not lawfully present” under Obamacare can’t buy insurance from the exchanges, period, meaning that much of the individual market will be closed to them. So they’ll continue to represent a burden on hospitals that will have to be cross-subsidized by people and employers actually paying for insurance (in New York City in 2011, 40 percent of uninsured patients were illegal immigrants). HHS explained, in laying out the bill’s benefits for even illegal immigrants:
The ACA provides additional funding for CHCs, an important source of care for the uninsured, although current budget cuts have limited the funds made available to CHCs in the health reform bill (NCSL, 2011b). Additionally, the reduction in the total uninsured population in the US following health reform may enable providers to cross-subsidize care for the remaining uninsured, a quarter of which will be undocumented immigrants.
Basically, if these amnesty recipients aren’t likely to be public charges, it would actually be a good thing if they were subject to Obamacare. There are some conservatives who might like the exchanges to collapse under their own poorly underwritten weight, but otherwise, if these amnestied immigrants are the kind of people who “won’t be dependent on government” (as Rubio claims) and therefore won’t cost much in subsidies, other Americans will benefit if Obamacare pushes them onto the exchanges (for one, because those legalized tend to be young people who will subsidize the old). Senator Rubio says in his answer that Obamacare “will in essence be unsustainable” if illegal immigrants are included — presumably he thinks it already is, but if he really thought the immigrants we’re legalizing could support themselves, letting them into Obamacare would actually make it a little less unsustainable.
A large part of the justification for the Gang of Eight’s amnesty is the idea that it will improve the economic prospects of illegal immigrants — I don’t doubt that that’s the case, and it’s possible that will make those poor enough for some means-tested federal benefits now not eligible in ten years, when they get green cards – but Obamacare’s sheer munificence presents a particular problem here too. Consumers on the individual market are eligible for subsidies up to 400 percent of the federal poverty level, meaning that lots of immigrants aren’t going to climb out of the subsidized category by the time that the ban on federal benefits for them expires. The category of those receiving Obamacare subsidies, of course, will include millions of native-born Americans, but that just demonstrates how the current size of our welfare state makes so many Americans beneficiaries of means-tested programs – and makes most legal and illegal immigrants into them, too. The choice to exclude them from Obamacare reflects that Senator Rubio knows that, even as he claims otherwise.






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