I agree with you regarding the legal context and the ideological messaging. I do question your use of CA as evidence of policy failure.
I am a government employee in CA. My job is to ensure that all retired employees from my municipality have appropriate health coverage. It is true that CA budget for 2025 has a $12 billion shortfall. It's not entirely clear that coverage for undocumented migrants is the straw that broke the camels' back, since numbers that are being reported are for Medical-Cal expenditures *over all* rather than specifically attributed to undocumented migrants.
Additionally, providing baseline coverage to undocumented migrants helps to reduce the cost of services that they access by going to emergency rooms. In the US, emergency rooms are not allowed to deny medical treatment based on immigration status. This is creates a greater drain on resources than providing basic coverage does (because every service rendered in an ER is more expensive than the same service at an urgent care center or public health clinic.)
Furthermore, denying service to a subset of people living in a region is bad public healthy policy. We need only look at the measles epidemic to consider what could happen if undocumented babies aren't vaccinated. Or consider the potential public health crisis if an undocumented gay man is denied PrEP, or an undocumented worker sheds infectious biohazard on a public street.
You and I probably agree that the better approach to discussing this decision is without the ideological, racialized baggage that plagues political extremism.
Thanks for this—I really appreciate your input, especially coming from someone familiar with how the system actually works. My brother is an ER nurse, and he frequently treats patients who are here illegally, so I’ve seen firsthand how that creates strain in emergency care.
That said, my main concern with this bill is how it expands eligibility in a way that, while technically legal at the state level (as long as federal funds aren’t used), still runs fundamentally counter to federal law.
You’re absolutely right that public health is a serious and immediate concern—and I don’t disagree. I know medical professionals can’t turn patients away based on immigration status, and I understand the ethical weight of that. But we have to be cautious about letting policies like this become normalized, especially when they sidestep immigration processes that so many people are waiting through, legally and patiently.
I’m approaching this from a place of principle—about fairness, legal integrity, and national sovereignty. How to navigate both the short-term, immediate problems and the long-term structure is complicated—no question.
I agree about fairness and legal integrity; they are pillars of participatory democracy and must be abided. Not so sure about "national sovereignty" especially as it's been practiced these days. Now, if there is evidence that denying health care to undocumented migrants is a threat to national *security* I'd be much more interested in hearing more.
In fact, one of the chief differences in our political parties is (or used to be) where states' rights end and national sovereignty begins. If there is no federal law barring undocumented migrants from accessing health care, then the 10th Amendment gives states the right to proceed.
Also (and apologies for beating a dead horse) SCOTUS right now is deciding a case that is connected to the question of national sovereignty. The current administration is arguing that questions regarding citizenship cannot be adjudicated universally (i.e. "nationally") but rather must be processed through the appellate districts.
It would be difficult for the federal government to challenge health care access to undocumented migrants universally if they are taking the position *right now* that even a US Constitutional right cannot be granted a universal injunction.
I think I’m reading your post incorrectly. So, the Trump administration is arguing that lower courts do not have the judicial authority to issue nationwide injunctions?
That’s really interesting—I haven’t been following that case. It’s surprising that the administration would take a stance that avoids setting a national precedent on something as foundational as citizenship.
From what I've been reading, DOJ knows that their birthright citizenship argument is a losing prospect. If they are able to stop universal injunctions, then it would slow-down the legal adjudication process so they can deport more people before the question is heard by SCOTUS.
I agree with you regarding the legal context and the ideological messaging. I do question your use of CA as evidence of policy failure.
I am a government employee in CA. My job is to ensure that all retired employees from my municipality have appropriate health coverage. It is true that CA budget for 2025 has a $12 billion shortfall. It's not entirely clear that coverage for undocumented migrants is the straw that broke the camels' back, since numbers that are being reported are for Medical-Cal expenditures *over all* rather than specifically attributed to undocumented migrants.
Additionally, providing baseline coverage to undocumented migrants helps to reduce the cost of services that they access by going to emergency rooms. In the US, emergency rooms are not allowed to deny medical treatment based on immigration status. This is creates a greater drain on resources than providing basic coverage does (because every service rendered in an ER is more expensive than the same service at an urgent care center or public health clinic.)
Furthermore, denying service to a subset of people living in a region is bad public healthy policy. We need only look at the measles epidemic to consider what could happen if undocumented babies aren't vaccinated. Or consider the potential public health crisis if an undocumented gay man is denied PrEP, or an undocumented worker sheds infectious biohazard on a public street.
You and I probably agree that the better approach to discussing this decision is without the ideological, racialized baggage that plagues political extremism.
Thanks for this—I really appreciate your input, especially coming from someone familiar with how the system actually works. My brother is an ER nurse, and he frequently treats patients who are here illegally, so I’ve seen firsthand how that creates strain in emergency care.
That said, my main concern with this bill is how it expands eligibility in a way that, while technically legal at the state level (as long as federal funds aren’t used), still runs fundamentally counter to federal law.
You’re absolutely right that public health is a serious and immediate concern—and I don’t disagree. I know medical professionals can’t turn patients away based on immigration status, and I understand the ethical weight of that. But we have to be cautious about letting policies like this become normalized, especially when they sidestep immigration processes that so many people are waiting through, legally and patiently.
I’m approaching this from a place of principle—about fairness, legal integrity, and national sovereignty. How to navigate both the short-term, immediate problems and the long-term structure is complicated—no question.
I agree about fairness and legal integrity; they are pillars of participatory democracy and must be abided. Not so sure about "national sovereignty" especially as it's been practiced these days. Now, if there is evidence that denying health care to undocumented migrants is a threat to national *security* I'd be much more interested in hearing more.
In fact, one of the chief differences in our political parties is (or used to be) where states' rights end and national sovereignty begins. If there is no federal law barring undocumented migrants from accessing health care, then the 10th Amendment gives states the right to proceed.
Also (and apologies for beating a dead horse) SCOTUS right now is deciding a case that is connected to the question of national sovereignty. The current administration is arguing that questions regarding citizenship cannot be adjudicated universally (i.e. "nationally") but rather must be processed through the appellate districts.
It would be difficult for the federal government to challenge health care access to undocumented migrants universally if they are taking the position *right now* that even a US Constitutional right cannot be granted a universal injunction.
I think I’m reading your post incorrectly. So, the Trump administration is arguing that lower courts do not have the judicial authority to issue nationwide injunctions?
Crazy, isn't it?
https://www.usnews.com/news/national-news/articles/2025-05-15/supreme-court-considers-limiting-nationwide-injunctions-what-to-know
That’s really interesting—I haven’t been following that case. It’s surprising that the administration would take a stance that avoids setting a national precedent on something as foundational as citizenship.
From what I've been reading, DOJ knows that their birthright citizenship argument is a losing prospect. If they are able to stop universal injunctions, then it would slow-down the legal adjudication process so they can deport more people before the question is heard by SCOTUS.