Obamacare

Immigration Reform Meets Obamacare

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credit: stringberd / Foter.com / CC BY-NC

Another day, another hold up for the immigration overhaul currently making its way through Congress. This time it's health care—and in particular, Obamacare. The Washington Post reports that House Republicans are considering proposals that would require unauthorized immigrants—who are already ineligible for Obamacare's insurance subsidies, but are also exempt from the law's health insurance mandate—to purchase health coverage anyway, no subsidies included. The GOP is also looking at a proposal that would deny unauthorized immigrants subsidized treatment at emergency rooms, under the theory that forcing them to comply with a mandate would mean they have coverage already.

To some extent, this is just a Republican delaying tactic. Immigration overhaul legislation seems likely to pass in the Senate, but it's far from certain to pass in the House. That's where this is fight is happening.

But to the extent that it's anything aside from that, it tells us a little bit about how Obamacare continues to shape the national political discussion, even on issues that aren't primarily about health care. As the Post report says, "The insertion of the politics of health-care reform — one of the most polarizing issues in Washington — into the immigration debate threatens to split open the emerging bipartisan coalitions that are crucial to passing a bill." It's an illustration, in other words, of how thoroughly Obamacare has poisoned national political discussion. The controversy over the law, driven by its continued lack of public support, is bleeding over into other issues.

It also suggests the trade-offs that arise between welfare-state generosity and free immigration. Democrats were not entirely unaware of this when they passed Obamacare; that's why the law prohibits illegal immigrants from receiving insurance subsidies, and why illegal and even recently legalized immigrants are generally restricted from receiving Medicaid. Yet even still, the health care overhaul is creating headaches for immigration reformers.

None of which is to say that it's not also a convenient way for Republicans to push back against the legislation. And in that respect it tells us something about the GOP's penchant for tactical opportunism, and its shallow policy foundations, especially when it comes to health care. In theory, the GOP is the party that opposes the mandate. Yet now GOP legislators are not only proposing one of their own, they are defending it in the name of "individual responsibility"—the same language used by both Mitt Romney and the Obama administration to defend their mandates. It's not exactly surprising, given that Republicans helped invent and popularize the idea of an insurance mandate. But it is telling about the party's priorities: For some GOP legislators, consistent and principled opposition to the mandate is apparently secondary to the hope of slowing down an immigration overhaul plan.