Ronny Jackson wrong on unauthorized immigrant access to ballot, health care coverage

US Rep. Ronny Jackson, R-Amarillo, who is running for re-election in Texas’ 13th congressional district, made a startling claim about unauthorized immigrants on Twitter and received more than 6,000 replies.

Jackson tweeted Jan. 16: “By 2022, illegal immigrants will have MORE FREEDOM and easier access to health care and ballot boxes than most Americans… Just think about it.”

Jackson’s office did not respond to our calls and emails for Jackson’s source. So we went ahead and looked at the two aspects of his claim: unauthorized immigrants’ access to the polls and their access to health care.

Is it true that immigrants living in the US illegally have “more freedoms” and easier access to health care and the ballot box compared to most Americans?

No voting access for unauthorized immigrants

Immigrants who do not have legal residency in the United States cannot vote in federal and state elections, said Matthew Weil, director of the elections project at Washington’s Bipartisan Policy Center. The project studies and analyzes electoral legislation to ultimately inform policy makers.

Almost all locations in the US and all in Texas restrict elections to citizens. Even in the few places where non-citizens can vote in municipal elections, those places allow only legally present non-citizens to vote.

Weil pointed out that New York City is an example of the few places that allow non-citizens to vote in local elections. New York City allows Deferred Action for Childhood Arrivals but not all unauthorized immigrants to vote, the Associated Press reported in early January. There are no circumstances under which non-citizens can vote in federal elections.

“I don’t know of any jurisdiction that would allow someone who is undocumented here to have access to the ballot box,” Weil said.

There are an estimated 1.7 million undocumented immigrants in Texas, according to the Migration Policy Institute, a nonpartisan policy research organization. More than 20% of them have lived in the US for 20 or more years, according to the institute.

Virtually no health care through federal programs

Unauthorized immigrants are barred from federal health programs, said Anne Dunkelberg, associate director at Every Texan, an Austin-based nonpartisan political institute. These include Medicare, Medicaid, the Children’s Health Insurance Program, and coverage through the Affordable Care Act marketplace.

Based on policy research, Every Texan advocates for Texas to expand Medicaid under the Affordable Care Act, which all but 12 states have done. This extension would not include immigrants living illegally in the United States.

Dunkelberg said there is one exception where providers could recoup the cost of treating an unauthorized immigrant in an emergency situation. Again, this emergency funding for providers is subject to the same restrictions as Medicaid in Texas for adult citizens.

“That’s why hospital emergency rooms can’t turn away people with real emergencies, regardless of whether they’re uninsured or what their residency status is. They have to treat you in real emergencies,” Dunkelberg said. “So there is a provision for emergency room visits by a very limited number of undocumented immigrants, not even all of them.”

Unauthorized immigrants have access to some state and local health programs that may be funded through federal grants. This patchwork of programs addresses some aspects of well-being such as mental health, immunization and communicable diseases.

However, these programs are not health insurance, Darkberg said. This maintenance is not free, and in many cases the program costs are tiered. These programs are also available to citizens.

At the local level, counties may choose to provide medical assistance programs to uninsured immigrants illegally residing in the United States. Those in need of long-term care who are not insured must meet certain income requirements. Dunkelberg said most of Texas’ major urban counties are choosing to serve uninsured, unauthorized immigrants.

States also have the option to offer prenatal care to women regardless of their immigration status through the Children’s Health Insurance program, said Ruth Wasem, professor of public policy practice at the LBJ School of Public Affairs at the University of Texas. Wasem said that option was created under former President George W. Bush.

Texas is one such state that opts for the perinatal CHIP (prenatal, childbirth, and postpartum care) program for unauthorized immigrants.

Even with limited emergency Medicaid, it’s an overstatement to say that unauthorized immigrants have “easier access” compared to most Americans.

“There is no aspect of this that is in any way superior to access for US citizens,” said Dunkelberg.

Although Jackson headed the White House medical department as the president’s physician in the Obama and Trump administrations, he appears to have been wrong about health care.

Our verdict

Rep. Ronny Jackson tweeted, “By 2022, illegal immigrants will have MORE FREEDOM and easier access to health care and ballot boxes than most Americans… Just think about it.”

Unauthorized immigrants do not have access to the ballot papers for federal, state and almost all local elections. Although immigrants may have access to some medical assistance programs depending on where they live, they are also not eligible for federal dollar health insurance coverage. They do not qualify for Affordable Care Act market coverage even if they pay the cost without an ACA grant.

We rate this claim as Pants on Fire.

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