Free Health Care for Illegals, Paid for by You

If you are poor and uninsured in Maryland’s largest county, there is a health clinic that will treat your stomach ache — even if you broke immigration laws to come to America.

Don’t try sneaking into one of Montgomery County’s 34 clinics if you are an American citizen from neighboring Frederick County, however. The low-income health program is for Montgomery residents only — and administrators require patients to produce one of nine different forms of identification as proof of address.

That bit of irony is not uncommon. According to a survey by the Wall Street Journal, 20 of the 25 U.S. counties with the largest populations of illegal immigrants do not consider legal status when assessing eligibility for subsidized health care. But most enforce residency requirements.

“A veteran who can’t quite meet the residence requirement is out of luck,” said Steven Camarota, director of research at the Washington-based Center for Immigration Studies. “But if you’re not even supposed to be in the country, that’s OK.”

It is one of the many examples of illegal immigrants getting subsidized and even free medical care despite their status as illegal immigrants. Sometimes, it is the result of fraud or bureaucratic incompetence. In February, a Senate Homeland Security and Governmental Affairs Committee report estimated that the government had spent more than $750 million as of June 2015 on tax credits for people who could not verify their citizenship or legal immigration status.

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In other instances, illegal immigrants receive health benefits because local governments allow them to participate in county-run programs. That is the case in the 20 large-county health programs surveyed by the Journal.

In either case, taxpayers provide health care to people who are technically not allowed to even be living in the country. Camarota said the impact is as certain as the laws of economics: Either citizens pay higher taxes to cover the additional recipients or there is less medical care available for those citizens.

“It’s not free. It’s not consequence-free … either you accept the cost or you make them go home.”

“It’s not free. It’s not consequence-free,” he said. “Either you accept the cost or you make them go home.”

The numbers can be staggering. The Wall Street Journal estimated that the cost of providing non-emergency care to at least 750,000 illegal immigrants in 20 counties cost more than $1 billion a year. In Los Angeles County, which has the nation’s largest illegal immigrant population, 135,000 illegal immigrants received care. In Harris County, Texas, the number is 65,000. In Queens County, New York, it is 71,000.

Proponents argue that offering medical services to illegal immigrants saves money in the long run because health services can be provided much more cheaply than in emergency rooms, which are required under federal law to stabilize patients regardless of legal status or ability to pay.

Camarota said there may be good arguments to treat illegal immigrants. For instance, it might be in the public interest to control communicable diseases. But he questioned cost savings as a rationale.

“The research shows that the more health insurance you offer people, not surprisingly, the more health care they use,” he said.

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So while it is true that treating a minor illness at a clinic is, indeed, cheaper than treating a full-blown medical emergency in a hospital, the reality is that in many cases, people without insurance simply do without treatment and get better on their own. Camarota said it may well be cheaper overall to treat a smaller number of comparatively costly hospital visits than a much larger number of comparatively cheaper clinic visits.

Previous research by the Center for Immigration Studies indicted that immigrant households are heavy users of government-assistance programs, even though immigrants mostly are ineligible for such assistance. The reason is that U.S.-born children are eligible for those programs. In 2012, for instance, 51 of households headed by an illegal immigrant had someone in Medicaid. That was more than double the rate of households headed by native-born Americans.

“If you let illegal aliens stay, there is a cascading series of problems that’s only going to be solved by making them go home,” Camarota said.