Doctors to Trump: Deporting Illegal Immigrants Would Be Bad for U.S. Health

Doctors to Trump: Deporting Illegal Immigrants Would Be Bad for U.S. Health

REUTERS/Joshua Lott
By Millie Dent

The American College of Physicians has a message for Donald Trump and any other presidential contender advocating for mass deportation of illegal immigrants: Any plan to kick out those 12 million people from the country could have severe public health consequences.

On Tuesday, the doctors’ group, which represents 143,000 internists, released a statement urging physicians to take a stand against proposals for mass deportation. 

Related: Vast Majority of Americans Say Illegal Immigrants Should Stay

“Large-scale deportation of undocumented residents would have severe and unacceptable adverse health consequences for many millions of vulnerable people,” Dr. Wayne J. Riley, the groups’ president, said in a statement. “Numerous studies show that deportation itself, as well as the fear of being deported, causes emotional distress, depression, trauma associated with imposed family separations, and distrust of anyone assumed to be associated with federal, state and local government, including physicians and other health care professionals providing care in publicly-funded hospitals and clinics.”

That distrust, in turn, could result in sick people not getting medical attention, and in cases of patients with infectious diseases, it could even lead to a public health emergency with tremendous costs to the to the overall health care system, the group warned.

On the other hand, having illegal immigrants in the country carries health care costs, too. Medicaid pays around $2 billion a year for emergency treatment for illegal immigrants, Kaiser Health News reported in 2013, adding that the total represents less than 1 percent of total Medicaid costs. 

Related: Birthright Citizenship, the New Immigration Scam

Still, the American College of Physicians said doctors have an ethical obligation to advocate for the health interests of all people, without consideration of their residency status.

“Physicians and other health professionals must remind politicians and policymakers that deporting millions of vulnerable people would have adverse health care consequences, not only for the people directly affected and their families, but also for their local communities and for the United States as whole,” Riley said in the statement. “Instead, we need a balanced immigration policy that ensures access to healthcare for all U.S. residents while recognizing that we need appropriate controls over who is admitted.”

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Ahead of a House Ways and Means Committee hearing scheduled for Wednesday, the Joint Committee on Taxation prepared an analysis of the distributional effects of the 2017 Republican tax bill. The New York Times’ Jim Tankersley highlighted the fact that according to the JCT analysis, about 75 percent of the individual and business benefits of the tax cuts will go to filers earning more than $100,000 in 2019. And nearly half of the benefits will flow to filers earning over $200,000.

The Trump Budget's $1.2 Trillion in 'Phantom Revenues'

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KEVIN LAMARQUE/Reuters
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The $1.2 trillion in questionable revenue projections is in addition to the White House budget’s projected deficits of $7.3 trillion for the 10-year period. That total is itself questionable, given that the president’s budget relies on optimistic assumptions about economic growth and some unrealistic spending cuts, meaning that the deficits could be significantly higher than projected.

Republicans Push Ahead on Medicaid Restrictions

U.S. President Trump listens to reporters during bill signing ceremony in the Oval Office of the White House in Washington
JOSHUA ROBERTS
By Michael Rainey

The Trump administration on Friday approved Ohio’s request to impose work requirements on Medicaid recipients. Starting in 2021, the state will require most able-bodied adults aged 19 to 49 to either work, go to school, be in job training or volunteer for 80 hours a month in order to receive Medicaid benefits. Those who fail to meet the requirements over 60 days will be removed from the system, although they can reapply immediately.

The new work requirements include exemptions for pregnant women, caretakers and those living in counties with high unemployment rates and will apply only to those covered through the expansion of Medicaid under the Affordable Care Act. There are currently about 540,000 people on Medicaid in Ohio who receive coverage through the expansion, according to Kaitlin Schroeder of The Dayton Daily News, compared to roughly 2.6 million Medicaid recipients in the state overall.

Once implemented, the work requirements are expected to result in 36,000 people losing their Medicaid eligibility, according to state officials, though critics say the reductions could be significantly larger. Similar work requirements in Arkansas pushed 18,000 people off the Medicaid rolls in six months.

A larger GOP project: The creation of new work requirements is part of a larger effort by Republicans to limit the expansion of Medicaid, says The Wall Street Journal’s Stephanie Armour. Since the Affordable Care Act passed in 2010, 36 states have expanded their Medicaid programs under the ACA and the number of people in the program has grown by 50 percent, from roughly 50 million to about 75 million. But many red-state governors have expressed concerns about the cost of Medicaid expansion and worries about a lack of self-sufficiency among the able-bodied poor, and are embracing new limitations on the program for both fiscal and political reasons.  

In 2017, the White House in 2017 gave states the green light to explore ways to limit the reach and expense of their Medicaid programs. Governors have proposed a variety of new rules, which require waivers from the federal government to enact. Kentucky, for example, wants to drug-test Medicaid recipients, and Utah wants a partial expansion and a cap on payments. Kaiser Health News summarizes the variety of waivers states have requested, which are governed by Section 1115 of the Social Security Act, in the chart below. 

Legal challenges: Efforts to restrict Medicaid have received legal challenges, and U.S. District Judge James Boasberg blocked work requirements in Kentucky last year. The same judge, who has expressed doubts about the administration’s approach to Medicaid, will rule on the legality of work requirements in both Kentucky and Arkansas by April 1.

The bottom line: The Trump administration is seeking fundamental changes in how Medicaid works. Even if Boasberg rules against work requirements, expect the White House and Republican governors to continue to push for new limitations on the program.

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Trump budget arrives on Capitol Hill in Washington
KEVIN LAMARQUE/Reuters
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