I have a friend I’ll call Maria. She lives in San Francisco, but her story is very probably the same as any number of Marias in Atlanta, New York, Chicago and elsewhere. You may not know her, but I’ll bet your paths have crossed.
Maria came here from Mexico 22 years ago. She has never applied for citizenship, largely because for the first few years she was in the country her English skills were so limited it would not have been remotely possible. Recently she has been afraid to try. Maria has a 20-year-old undocumented daughter, an extraordinarily smart illegal immigrant/recent college graduate niece and a large, extended family of mostly undocumented immigrant adults and American citizen children. The niece, tired of living in a very rough part of town, went online a few years ago and found them some minimally affordable rental housing toward the ocean. They have a strong sense of belonging.
Maria and the other women clean houses for a living; the men work for landscaping companies. They drive cars without licenses because they can’t get licenses. But they are little threat due to the fact that one minor brush with the law and (Maria’s daughter explained to me in some detail) you’re out $1,000 including towing charges and fines.
Maria’s family does not do in-home care; however, there is another large, mostly undocumented community of Pacific Islanders who are highly recommended and routinely called upon when seniors (and others) here require but cannot afford extended nursing care. Not nurses by a long shot, they are nevertheless highly skilled.
Whenever Maria or other members of these communities need medical care they go to the county hospital. If the need is sudden or extreme, they go to the emergency room. Either way, they pay small amounts and they get excellent care. I’m grateful for that. They are all truly good people, honest, hard-working and contributing members of the larger community. They don’t pay income taxes (and have no Social Security accruing) but they buy local, pay their rents on time and add to the economy.
I do not support illegal immigration and am SURELY not advocating health insurance coverage for the undocumented, the very mention of which is enough to sink any reform in a New York minute. But it is a subject of contention constantly just below the national surface — or sometimes above the surface, as with the ill-mannered Joe Wilson. As reported last week in the San Francisco Chronicle (and widely elsewhere), the current policy is clear:
Under long-standing federal policy, people who are in the United States illegally don’t qualify for federal health programs, and the current proposals for reform in Congress hold to that. With the exception of limited emergency Medicaid primarily for pregnant women and children, and some hospital funding, federal dollars do not pay for the care of people who are in the country illegally.
The health care reform bill in the House explicitly bars “undocumented aliens” from receiving federally subsidized health benefits. A Senate version doesn’t address the issue, suggesting that current policy would remain unchanged. A second Senate bill has yet to be released.
Some would have us go farther, requiring a system verifying immigrant status to be incorporated in the final health bill.
“If you don’t have a provision that clearly requires applicants’ immigration status to be verified, just to state that illegals won’t be covered is misleading,” said Yeh Ling-Ling, executive director of the Alliance for a Sustainable USA in Oakland.
Opponents argue that such verification systems would add a layer of bureaucracy and cost, and unintentionally screen out U.S. citizens who lack proper documentation. They also contend that denying a segment of people access to health care, even if they are illegal residents, could increase costs for emergency care as well as the risk for contagious disease in the general population.
However angry those are who are raising their voices about “illegal aliens,” that last sentence is worth consideration. If you cannot bring yourself to care much about the health of uninvited fellow residents of our corner of the planet, you may still want to look at this reality: treating colds in emergency rooms is an expensive folly; colds left untreated for want of an option breed more colds.
A lot of the anger is easy to understand. The economy has tanked, times are tough, you gotta blame somebody. But until all we documented citizens are ready to quit eating strawberries and drinking wine, and to forgo such niceties as in-home care and mopped kitchens, we would probably do well to care about the lives of our undocumented neighbors.