Progress Illinois

Over the past couple of day, we've highlighted statements of disgust from Illinois congressmen and candidates about the restrictive anti-choice amendment added to the House health care bill that passed last weekend. But abortion isn't the only hot-button issue that could complicate the Democrats' reform effort. Immigration is emerging as a potential sticking point, as well.

Lawmakers in both chambers have decided that insuring undocumented immigrants is not politically feasible. But as the final details are ironed out, Republicans and some Democrats are working to limit the assistance and consumer protections available to undocumented and legal immigrants alike. Legal immigrants who have been in the country for less than five years would not be eligible for Medicaid and Medicare, following current law, even though they are eligible for government subsidies on the exchange. And while the House bill allows those in the country illegally to purchase insurance on the health insurance exchange with their own money, the Senate is likely to bar them entirely.

Immigrant rights advocates aren't too pleased that protections for immigrants, who face mounting disparities in health care access and outcomes, are eroding. If the conference committee bill tracks more closely to the Senate version, Rep. Luis Gutierrez says the White House won't be able to count on his vote. From the Washington Post:

"I am not going to vote for a health-care bill that includes provisions that exclude people using their own money to go to the exchange regardless of their immigration status," said Rep. Luis Gutierrez (D-Ill.). "It is silly and stupid. If we do not allow them to purchase it, their communities will suffer. Their children will suffer."

This is a tricky position for Gutierrez. On the one hand, he has a lot to lose by voting against health care reform. A massive 32.2 percent of residents in the 4th district lack insurance, the 15th highest rate for non-elderly people of congressional district in the nation. But that number is high in large part because the vast majority of his constituents are working class immigrants (both legal and undocumented).

On the merits, Gutierrez is most certainly in the right. The cost of providing free emergency and charitable care to the nation's uninsured, many of whom are immigrants, is roughly $1,000 per individual with insurance per year. It's a hidden tax on all of us. Allowing this population to purchase public insurance would relieve local and state government hospitals who administer the care. Undocumented workers are on average younger and healthier than the U.S. average, so including them in the risk pool would likely help lower premiums across the board. And from a public health standpoint, it's undoubtedly a good idea to protect people who routinely work in the service sector, particularly the food preparation industry.

But in Washington, petty cultural politics can easily railroad common-sense policy. It's good to see Gutierrez pushing back.