Statement of Kevin Appleby

Kevin Appleby
Director of Migration and Refugee Policy
United States Conference of Catholic Bishops
Conference call with media, November 23, 2009

The U.S. Conference of Catholic Bishops (USCCB) favors the inclusion of immigrants in health-care reform.  Legal immigrants, who are on a path to U.S. citizenship and pay taxes, should have access to health-care coverage equal to U.S. citizens.  Undocumented immigrants, the vast majority of whom work and contribute to our economy, should not be denied purchasing their own health-care coverage.

During Senate consideration of health-care reform, the U.S. bishops’ advocacy will focus upon 1) lifting the five-year ban on legal immigrants having access to federal health-care benefits, including Medicaid, and 2)  removing the ban on undocumented immigrants using their own money to buy coverage through the health-care exchange.

For legal immigrants, Congress has yet to write the right prescription.  Although legal immigrants are eligible for subsidies to purchase health-care under the Senate bill, those at the bottom rung who live near or below poverty will struggle to purchase adequate coverage, even with subsidies.   Both the House and Senate bills fail to lift the ban, imposed in the welfare reform bill in 1996, which prevents legal immigrants from enrolling in Medicaid.   For many of these poor legal immigrants and their families, Medicaid is their best option for coverage.  In fairness, they should be eligible for programs for which they pay taxes.

The House bill rightly permits undocumented immigrants to purchase health-care coverage in the health-care exchange using their own funds.  The Senate bill does not, which we believe is contrary to the general public health and sound public policy.   Without primary coverage, undocumented immigrants will most likely depend upon emergency rooms for their primary care, when their health conditions are more serious and more costly.  By letting the undocumented buy into the exchange, the risks and costs of the new health-care system will be borne by more participants, keeping the costs of the system lower for everyone.

Including immigrants in health-care reform would help make health care more affordable and make us healthier as a nation.  It also would make coverage accessible to the most vulnerable among us.  Is that not the point of health-care reform?   The USCCB will work to ensure that any final bill improves health-care access for immigrants, who continue to be a part of our communities and nation.