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The question of whether illegal immigrants should be entitled to some form of health coverage in the United States sits at the uneasy intersection of two contentious debates: health reform and immigration reform. Befitting this place, the rhetoric surrounding the issue has been exponentially heightened by the multiplying effects of combining two vitriolic debates. On one side, it is argued that the United States has a moral obligation to provide health care to all those within its borders needing such assistance. On the other, it is argued with equal force that those illegally present in this country should not be entitled to take advantage of public benefits. Rather than meaningfully engaging each other, these sides simply square off across a chasm of absolutes. The purpose of this article is to chart a middle course between these extremes that focuses on the practical aspects of the issue while relegating hyperbole and high-minded moral claims to the side. It seeks to answer two questions: First, whether extending health coverage to illegal immigrants is mandated by Constitutional law? Second, whether there are compelling policy reasons for extending such coverage, even if extending coverage is not legally mandated? The conclusion of this article is that while health coverage for illegal immigrants is not required under prevailing constitutional norms, extending coverage as a matter of policy would serve the broader interests of the United States. Extending coverage would be beneficial both as a matter of economics and public health, meaning the spillover benefits to extending coverage would reach all U.S. citizens and all those already entrenched in the U.S. health care and health insurance systems. Although it seems unlikely that the recommendations of this article will, in reality, bridge the gaps between the warring sides, its benefits lay in its pragmatic and practical sketch of how a solution may be reached. Thus, at the least, it presents a blue-print on how best to approach this contentious issue.

Publication Citation

23 Health Matrix 197-236 (2013)