Conservatives love to perpetuate the misguided notion that “Obamacare” gives free health coverage to illegal immigrants. Many reference this viral quote, which they falsely attribute to economist Ben Stein, when complaining about how Obamacare will provide health care coverage for non-citizens. Unfortunately, their argument is completely invalid:
Fathom the hypocrisy of a government that requires every citizen to prove they are insured… but not everyone must prove they are a citizen. Now add this: Many of those who refuse, or are unable, to prove they are citizens will receive free insurance paid for by those who are forced to buy insurance because they are citizens.
Conservatives have chosen to take his statement, along with other anti-Obama rhetoric, and use it as yet another rallying point in their opposition of the Affordable Care Act (ACA). According to conservatives, Obamacare allows illegal immigrants to receive lots of free health care at the expense of American taxpayers.
In reality, both legal residents and illegal immigrants are, have been, and will continue being covered under the Emergency Medical Treatment and Active Labor Act (EMTALA). The act, which was signed into law by the conservative-favorite, former President Ronald Reagan, in 1986, allows for uninsured people to receive emergency medical care.
Prior to the passage of EMTALA, patients coming into an emergency room suffering from a true emergency could have their care delayed or denied while waiting for proof of insurance or the ability to pay for care. Patients often had no right to treatment or even evaluation, and could be turned away even in life-threatening situations.
This means that people who are uninsured or otherwise unable to afford health care can go to an emergency room and receive care, in life-threatening situations. It does not mean that illegal immigrants or uninsured citizens are magically signed up for free health insurance.
EMTALA also allows pregnant women to have their children delivered in a hospital. Sadly, many conservatives even view these emergency care allowances, provided under Reagan’s act, disdainfully.
Their contempt for providing medical care to any person who is faced with an emergency situation or the delivery of a child is striking, particularly given their collective support of “life.”
As Sandhya Somashekhar of Wonkblog so condescendingly points out, “A large percentage of that is labor and delivery, because so many of those who ‘qualify’ are pregnant women. And of course, all the little resulting babies will be U.S. citizens.”
The notion that one could qualify for emergency Medicaid is misleading, given that EMTALA provides emergency care to anyone currently in the country who is in need of it, therefore no qualification is required other than geographical situation.
Section 1312 (f)(3) of the Affordable Care Act expressly denies health insurance coverage to illegal immigrants:
Access limited to lawful residents. If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.
Even legal, documented immigrants who have been in the country for less than 5 years cannot qualify for health care coverage under federal law. When uninsured or underinsured residents, illegal immigrants, or legal immigrants who have been in the country for less than 5 years require emergency medical treatment, they receive a bill for their treatment.
If the patient is unable to pay the bill, which is likely given the lack of insurance, the cost goes to a combination of the federal government, state governments, and taxpayers. Shortly after EMTALA was passed, lawmakers created a state-federal health insurance program that is mostly used to reimburse hospitals for emergency medical care of illegal immigrants. The funding, about $2 billion a year, is less than one percent of the cost of Medicaid, and primarily goes toward health care costs for pregnant women.
Reasonably, or so it would seem, one would not both argue the difficulties of signing up for health insurance under the Affordable Care Act, based on the extensive amount of personal information required, as well as argue that the law freely distributes health insurance coverage to illegal immigrants. Yet, some Republicans have done just that.
Several Republican governors attempted to ban ACA health insurance outreach for legal citizens based on the notion that outreach counselors could theoretically steal personal information required to sign up for coverage. In September, Florida Gov. Rick Scott effectively banned outreach counselors, intended to aid residents in signing up for Obamacare, from health departments across the state.
Incidentally, Medicare and Medicaid fraud by American citizens costs the government billions of dollars a year. The Department of Justice website is constantly filled with news stories of citizens defrauding the government of millions through fraudulent medical supply companies, pharmacies, and clinics. Medicare fraud alone costs the government more than $60 billion a year, and some experts believe the cost to be twice that amount, according to ABC News.
Even Gov. Scott, who is staunchly opposed to the Affordable Care Act, has defrauded the government. Scott was the creator and CEO of the health care company Columbia/ HCA, which was responsible for a massive health care fraud rip-off of the government. In 2000, the company was hit with the largest government fraud settlement in US history – $840 million in criminal fines and civil damages and penalties.