At long last, President Joe Biden is moving to make DACA recipients eligible for Medicaid and Affordable Care Act insurance marketplaces — programs they pay for, and have long desperately needed, but been shut out of for reasons that are purely political in nature.
There is zero public health rationale for excluding undocumented immigrants from government-funded health insurance programs, and all other rationalizations quickly twist themselves into pretzels. Ultimately, as the COVID pandemic made abundantly clear, the health of one person is not the issue of only that one person.
Even setting aside basic human decency, it’s a poor investment to shut certain people out of access to health care. That goes for more than just contagious diseases; as has been established again and again, preventive care is not only better for people’s health but much cheaper in the long run than dealing with what could have routine, simple matters in the pricey emergency room.
Unless anyone is advocating for just letting the uninsured and undocumented die of treatable illness — and even the most virulently xenophobic political figures would be hard pressed to go that far — then we have to intervene at some point. Waiting until there’s a crisis is not only much worse for the patient but is needlessly more expensive. Everyone loses, for nothing more than political grandstanding.
A salient example is the case of dialysis. The blood cleansing procedure is needed periodically to prevent a person with malfunctioning kidneys from having potassium buildup strain their hearts to the point of being fatal. It’s non-negotiable; there’s no alternative treatment, and those patients who need it must get it at routine intervals, or die.
Yet for the uninsured, the only way to get it is often crisis dialysis, waiting until they are at grave risk to make it into an emergency room and get treatment. It’s barbaric, and nonsensical. This policy is a good start, and let it be just another step in the longer road to giving all people access to the health care they need.
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