California State Senator Ricardo Lara (D-Long Beach) has done us all a great service by introducing a new bill, the Health For All Act, that would commit California taxpayers to financing Medi-Cal coverage for low-income unauthorized immigrants. As a recent analysis from the Migration Policy Institute reveals, 44 percent of unauthorized immigrants in the U.S. live in households earning less than 138 percent of the federal poverty level, and the same is true of 63 percent of unauthorized immigrant children. Assuming California’s unauthorized immigrant population follows this pattern in broad outline, Lara’s proposal would represent a significant expansion of Medi-Cal. Yet as Adrian Florido of KPCC reports, Lara “still has not worked out how much his bill would cost, or how it would be funded.”
The reason Lara has done us a service is that he has clarified the immigration debate. Many advocates of amnesty, or rather earned legalization, insist that unauthorized immigrants granted legal status will be barred from accessing various benefits that are designed to better the lives of the very poor, despite the fact that these immigrants, most of whom have very limited skills, are unlikely to be able to afford to be able to afford their own insurance coverage. This strains credulity, not least because the children of unauthorized immigrants granted legal status will eventually become part of the American workforce, and perhaps even the American electorate. Denying these immigrants benefits will as a general rule mean denying their children benefits as well. We deny a wide range of benefits to unauthorized immigrants now, but Lara is demonstrating that the politics of doing so are changing along with the composition of the California electorate. Today Lara’s proposal sounds outlandish and extreme, and he all but acknowledges that he’s given it little thought. Tomorrow it might become an urgent political demand, complete with raucous street protests and hunger strikes.
This, ultimately, is the case for a more selective immigration policy. If we only welcome immigrants who have the skills they need to achieve economic self-sufficiency, we won’t need legislation like Lara’s. Indeed, such a policy would raise the average skill level of the U.S. workforce and make it easier to finance programs like Medi-Cal for the poor people, native-born and foreign-born, who already reside in the U.S., of whom there are very many. But if we welcome less-skilled immigrants who are unlikely to ever achieve economic self-sufficiency as we enter the “second machine age,” we must choose between welcoming a small number of less-skilled immigrants and treating them generously, by, for example, providing them and their children with high-quality medical care and education to ensure that the next generation has a decent shot at achieving economic self-sufficiency, or welcoming a large number of less-skilled immigrants and accepting that we won’t offer them Medi-Cal and other benefits, and that their children will languish on the bottom rungs of American society. And no, we can’t just welcome everyone and treat everyone generously, as doing so would stretch what is an already overburdened welfare state to the breaking point. One of the reasons I love libertarians is that they’ll generally acknowledge that a laissez-faire immigration policy means importing an immigrant underclass, and that moving “50 million people from sleeping-on-the-floor poverty to sleeping-on-a-mediocre-mattress poverty” is good enough, whether or not those living in sleeping-on-a-mediocre-mattress poverty have access to Medi-Cal. My sense is that most Americans would balk at this notion, and that they should.