Medical Journal Articles Urge Same Health Care Coverage for Illegal Aliens as Citizens

The latest New England Journal of Medicine contains two advocacy articles that essentially argue that the country should provide health care for illegal immigrants, no questions asked.

The first, discusses the 1.1 million elderly people with no legal right to be here, who as a result, do not qualify for Medicare or federal Medicaid funding, which the authors call “dual ineligibility.” The article argues that these illegal residents should be covered by Medicare if they paid taxes, but realizing that is a political nonstarter, urge a combination of strategies. These range from states authorizing payments under Medicaid, to funding community health centers, to illegal elders being covered by their legal adult children’s health insurance.

But what the authors really want is to erase all distinctions between citizens and legal foreign residents and those who are here illegally when it comes to medical coverage:

National discussions about health care access are crucial for the aging U.S.-citizen population and are equally warranted for dual-noneligible people. Though the solutions we propose are not exhaustive, they may serve as a vital starting point for a dialogue about how payers, providers, and policymakers can ensure that all older adults in our country, irrespective of immigration status, can lead dignified and healthy lives.

The second column is even worse. It decries Texas for requiring that the costs of paying for the medical expenses of illegal aliens be calculated and reported:

On Halloween morning, 2024, Texas physicians received disturbing news about hospital policies set in compliance with Governor Greg Abbott’s Executive Order GA-46 — a rule that mandates the collection and reporting of information on patient citizenship status during intake. A similar measure, Senate Bill (SB) 1718, was signed into Florida law by Governor Ron DeSantis in 2023. Both states now require hospitals to identify undocumented patients and report their costs of care to state health administrations.

One would think that kind of basic information would be important to understand in the creation of policies around coping with illegal immigration. But no:

But as health policy researchers and clinicians, we believe this ideologically motivated rule will cause irreparable harm. GA-46 erodes trust between patients and clinicians; risks violating legal protections afforded to all patients, regardless of citizenship status; and undermines the integrity of the medical profession. It poses threats to civil and human rights, contradicting longstanding U.S. policy objectives and international law.

As an example, the authors complain about a patient who had been living in Texas illegally who was detained after she sought medical care. Oh, the injustice! The fact that the woman was living under a false identity made not a dent on these “ethicists.”

Making matters worse, red states might follow Texas’s lead:

Perhaps most important, we believe GA-46 sets a dangerous precedent. In the aftermath of the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, restrictive abortion laws passed in Texas quickly influenced policies in other states. The same could happen with GA-46. Like abortion bans that impose criminal penalties on clinicians attempting to provide lifesaving care, anti-immigrant policies such as GA-46 and SB 1718 transform hospitals from places of healing into spaces for enforcing harmful political agendas. As a second Trump administration approaches, the dangers of this precedent are even more alarming. Federal support could lead to the passage of similar directives nationwide, thereby deterring immigrants from seeking necessary care.

Sick people need care, to be sure. But they don’t have a right to sanctuary in obtaining it any more than would any other lawbreaker.

Adding to their support for illegality, the authors urge doctors to resist reporting laws.

Our colleagues in Texas have criticized GA-46 on social media, despite threats from Governor Abbott to withhold federal hospital funding for noncompliance. Physicians in Texas and Florida must continue to inform patients of their right to refuse disclosure of their citizenship status. . . .

These articles — published simultaneously in one of the world’s most influential medical journals — are, for all practical purposes, pro-illegal immigration. All rights, no consequences.

And talk about impractical. Neither column addresses the significant magnet effect that would be caused by giving illegal immigrants open access to medical care, which would lure people, including children, on a perilous journey. They fail to address the deleterious impact such open care policies would have on our already badly strained medical infrastructure. They don’t grapple with the social harm caused by rewarding lawbreaking, and the increased suffering that would be caused by a medical system made substantially more inaccessible because multitudes have poured over the border goes completely unmentioned.

Here’s a question that I have never heard a pro illegal immigration advocate answer: How many illegal immigrants are too many? If the authors of these articles get their way, we will soon find out.