What The GOP Is Talking About When They Talk About 'Healthcare For Illegals'
They're using anti-immigrant hysteria to justify dicking over hospitals and driving up costs for us all.
Welcome to Day Two of the government shutdown that we are having because Republicans want people to have to pay more for health care and the Democrats don’t. Federal workers aren’t getting paid, benefits are going to get screwed up, and the usual shutdown chaos will ensue. Fun!
The primary sticking point, of course, is that Democrats want to extend the Affordable Care Act subsidies that allow millions of Americans to afford health insurance. Without these subsidies, 26 million people who currently qualify for subsidies will pay more than double what they are currently paying, and 4 million people who currently have health insurance will not be able to afford it.
The other sticking point is that Democrats want to undo the massive cuts to Medicaid that will lead to even more people not having health insurance.
House GOP Thinks It's 'Beautiful' To Kick Millions Off Of Medicaid To Save Billionaires A Few Bucks
According to one analysis, these cuts will cause 51,000 preventable deaths a year, which I imagine would be pretty damned devastating for 51,000 families across the United States.
However, the Republicans are trying to make this whole thing about “Democrats are causing this shutdown because they want to take your money and give free healthcare to ‘illegals’ because they care about them more than they care about YOU!” instead.
Why? Well, probably because even they know that the subsidies are very, very popular. According to a poll from the Kaiser Family Foundation, 77 percent of Americans support extending them, including 91 percent of Democrats, 80 percent of independents, and 63 percent of Republicans.
But what is it that they are actually talking about? Let’s discuss!
So, first of all — yes, the state of California, for now, uses its own state funds to allow undocumented immigrants to sign up for Medi-Cal. This is not that, although personally, I obviously think that’s a good thing (because I’m not a monster). As of the notoriously grotesque Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), however, undocumented immigrants are, in fact, barred from receiving any kind of federally subsidized healthcare, including Medicaid, Medicare, Children’s Health Insurance Program (CHIP), or the aforementioned Affordable Care Act subsidies.
What we are actually talking about here, with regard to the shutdown, is emergency Medicaid, which accounts for just a teensy-tiny bit of those Medicaid cuts.
Emergency Medicaid is one of the very few exceptions to the PRWORA statutes. It allows hospitals to be reimbursed when they provide emergency medical care to those who are barred from receiving Medicaid but would otherwise qualify for it. This includes not just undocumented immigrants, but others who are lawfully present in the United States but who don’t yet have legal status.
“A lot of emergency health care at hospitals that are provided to illegal aliens, that was funded by the federal government,” JD Vance said in a FOX News interview on Wednesday. “We turned off that funding because, of course, we want American citizens to benefit from those hospital services, not to be taxed, and then to have those hospital services go to illegal aliens.”
However, this does not actually mean they will not receive those hospital services. Hospitals that accept Medicare are legally obligated to provide this care, under the Emergency Medical Treatment and Active Labor Act (EMTALA). Therefore, without emergency Medicaid, hospitals will be required to just absorb those costs. Does that save the average US taxpayer money? It does not! In fact, it will very likely lead to hospitals having to charge us more.
It’s not quite clear how Vance actually wants to see this work. Even if we were to get rid of EMTALA … does he want to see undocumented people rejected from hospitals and bleeding out in the streets? Does he want EMTs to make an educated guess as to an unconscious person’s immigration status? What does he think should happen if an undocumented child gets hit by a car? Neither he nor any other Republican has actually explained what it is they would like to see happen in these situations.
It is, however, quite clear that they are using their base’s hysteria over undocumented immigrants to dick over hospitals — many of which are in danger of closing already due to all of the Medicaid cuts. There will be, to the great disappointment of many of the MAGA faithful, no actual harm to undocumented immigrants as a result of the cuts to emergency Medicaid, just the hospitals that are legally obligated to treat them.
The second thing at issue has absolutely nothing to do, at all, with undocumented immigrants, but rather with allowing those who are what is called “lawfully present” to apply for certain federally funded healthcare programs, including Medicaid and CHIP. There are around 1.4 million people in the United States who fit this criteria, including DACA recipients, those with Temporary Protected Status, people in the process of getting their green cards, refugees, asylum-seekers who are not yet official, victims of trafficking, those who are here on parole status for urgent humanitarian reasons (for instance, those fleeing the war in Ukraine), and others.
Democrats say yes to healthcare for these people, because it’s pretty messed up to keep refugees and sex-trafficking victims from seeing a doctor. Republicans claim that it is necessary to bar healthcare for them because the Biden administration granted this status to too many people that they do not want to be here. The thing is, if they were to revoke the lawfully present status of those people, they would no longer be eligible for those programs. So, really, they’re just being cruel to the most vulnerable among us. They want those people, who are likely extremely poor, and their children, to not have healthcare.
Will this make health care better for people in the United States? It damn well will not. JD Vance can talk all he wants about how he wants “American citizens to benefit from those hospital services,” but that rings pretty hollow when the Republicans are also taking those services away from American citizens by allowing the subsidies to expire, instituting work requirements (which, by the way, will disproportionately hurt rural recipients due to the lack of jobs in their areas), causing (again, disproportionately rural) hospitals to shut down wards, lay people off, and even close entirely.
Indeed, rural clinics are already shutting down in anticipation of the cuts.
Confucius famously said, “Before you embark on a journey of revenge, dig two graves.” Trump, Vance and the MAGA faithful are so consumed by their desire to inflict pain on us, to inflict pain on immigrants, that they clearly don’t realize (or don’t care) that they are ultimately going to hurt their own people just as much, if not more.
PREVIOUSLY ON WONKETTE!
It’s abuse.
When somebody puts you in an impossible position and blames you for it, they’re abusing you.
Period.
Not-so-fun fact:
Went to the post office today to get more postcard stamps for the last of the postcards to voters I have for my group (LFG VA, PA, CA, & NJ!)
Display in front of the very nice person who helped me:
Merry Christmas 2025 from the White House! (IDK WTF it was for, cards or some shit)
Looked at that fucker and said “Bah humbug to you too!”
Nice post office employee was even nicer after that.
FUCK TRUMP AND FUCK MAGA, the end...