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Prospects for Undocumented Immigrants Receiving Government Health Benefits

With new bills in Congress and a new secretary ready to tackle the immigration issue, it seems likely that government benefits will be coming very soon.

While the $1.9 trillion American Rescue Plan Act does not make undocumented immigrants eligible for financial assistance to get health coverage, the Biden administration’s appointment of Xavier Becerra as Secretary of Health and Human Services as well as Democrats’ newly gained control of the Senate, albeit a tenuous one, provide some cause for optimism:

  • The new Congress: On March 18, the House passed a bill, the Dream Act of 2021, to give undocumented immigrants the chance to earn legal citizenship status. It now sits in the Senate, where the bill will have a tough hill to climb with 60 senators required for passage even though 72% of Americans favor passage. Because of the Senate filibuster rule, passing this bill will require support from at least 10 Republican Senators. Citizenship would enable young immigrants to access federal and state healthcare benefits that are currently out of reach.

  • Xavier Becerra’s confirmation HHS Secretary: A son of a Mexican immigrant mother, Becerra has long championed health benefits for undocumented immigrants. After Obama promised that undocumented immigrants would not receive any benefits under the Affordable Care Act, Becerra and other lawmakers were not shy about giving Obama a piece of their minds and it is likely he’ll do the same if Biden takes a similar stance. However, that won’t happen if Biden holds to his campaign-trail pledge to allow undocumented immigrants to buy into a public option-like health plan.

Politico reports that Becerra has multiple ways to assist undocumented immigrants. The simplest path would be to give them access to the Obamacare exchanges without any government subsidies. Becerra could also encourage states to expand in-state Medicaid programs to cover undocumented immigrants, which California is in the process of doing. Another option is to expand health insurance for DREAMers, who have temporary legal status in the United States but do not qualify for government healthcare programs.

To be sure, Becerra will face staunch opposition along the way. His long-time advocacy of healthcare benefits for undocumented immigrants was one reason why the Biden administration had so much difficulty getting Becerra confirmed by the Senate. Before he was nominated, an aide to Sen. Tom Cotton (R-Ark.), who had lobbied colleagues against Becerra’s nomination, said, “If he [Becerra] was confirmed, he could weaponize HHS as a mechanism to push for open borders, and legitimize the illegal alien agenda that he’s pushing for. That has gotten some attention on the Hill.”

Even among Hispanic lawmakers in his own party, Becerra’s undocumented immigrant agenda also faces headwinds. For instance, Rep. Henry Cuellar (D-Texas), a moderate says, “U.S. citizens should receive welfare and other benefits, that’s my position and my position is what helps Democrats. If you’re undocumented, you shouldn’t be getting healthcare and other benefits.” Rep. Cuellar says that he frequently hears from Hispanic constituents who urge him to take care of Americans first before helping undocumented immigrants.

Some Democrats also oppose providing non-health benefits to undocumented immigrants. In early February, 58 senators — including former presidential candidate John Hickenlooper (D-Colo.) and Sen. Gary Peters (D-Mich.), who chairs the Democratic Senatorial Campaign Committee — voted in favor of banning undocumented immigrants from receiving stimulus checks in a nonbinding vote.

It appears that the most viable way to provide health benefits to undocumented immigrants may be at the state level since the states can spend their Medicaid dollars any way they choose. For instance, six states – including California, New York, and Massachusetts – cover poor children in their states’ CHIP insurance programs regardless of their immigration status. As HHS secretary, it is expected that Becerra will encourage other states to extend similar benefits to undocumented children. Under Becerra’s leadership, the federal government could also allocate more funding to community health clinics heavily used by undocumented immigrants.

And public opinion may also be shifting towards providing health benefits to undocumented immigrants, at least in blue states. In a March 2021 report based on a survey it conducted, the Public Policy Institute of California (PPIC) found that:

“66 percent of Californians approve, up from 54 percent in 2015 (the last time PPIC asked this question). Support is far higher among Democrats (82%) and independents (57%) than among Republicans (20%). Overwhelming majorities of Latinos (83%), African Americans (77%), and Asian Americans (70%) are in favor, as are a slim majority of whites (51%).”

Given overwhelming Republican opposition to providing health benefits to undocumented immigrants, though, the more politically palatable path to accomplishing this in red states and at the federal level might be to give undocumented immigrants a path to citizenship. According to PPIC, “an overwhelming majority of Californians (85%) [including 68% of Republicans] say there should be a path to citizenship for undocumented immigrants, provided they meet certain requirements.” Unfortunately, this could take a while but as we’ve seen with past unexpected changes in public opinion, like the widespread acceptance of legalized gay marriage, public support for a pathway to citizenship could also happen faster than anyone expects. Here’s hoping!

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