Contention one is inherency
Immigrants refuse to participate in health care because of hierarchal service
(Kathryn Pitkin Derose, Ph.D. in health services, 2007, University of California, Los Angeles; M.P.H. in population and family health, University of California, Los Angeles; B.A. in comparative area studies-Latin America, Duke University, Nicole Lurie, MD, MSPH, is the Director of the RAND Center for Population Health and Health Disparities and Co-Director of the RAND Center for Domestic and International Health Security. She is also a Senior Natural Scientist and the Paul O'Neill Alcoa Professor of Health Policy at RAND, Prof. Nicole Lurie is senior natural scientist and Paul O'Neil Alcoa Professor of Policy Analysis at RAND. She is also Associate Director for Public Health at the RAND Center for Domestic and International Health Security, 2007, Health Affairs, 26, no. 5 (2007): 1258-1268, http://content.healthaffairs. org/cgi/content/full/26/5/1258 )



Stigma and marginalization. Immigrants’ vulnerability can also be influenced by factors related to stigma and marginalization. A variety of factors can contribute to this: differences in appearance (for example, wearing traditional dress), cultural and religious practices, language barriers, speaking with an accent (even among immigrants who speak English), and skin tone. Stigmatization of immigrant populations can be exacerbated by community concerns regarding the effects of immigration on community resources. A common theme in newspaper articles and opinion pieces of late is that immigrants, especially the undocumented, overburden the safety net and take away from "deserving" families, even though research suggests that immigrants in general and the undocumented in particular use relatively little health care.__30__ Being part of a stigmatized group can make immigrants reluctant to seek care because of concerns about poor treatment. If providers do not have adequate resources to serve immigrant groups, longer waits and frustration affect both patients and providers. As noted earlier, immigrants and those with limited English proficiency are generally less satisfied with their care than U.S.-born or English-speaking populations. Further, immigrants are more likely than U.S.-born populations to report discrimination in health care.__31__ Perceptions of being discriminated against can reinforce feelings of stigmatization and lead to decreased use of health services in the future. PRWORA has contributed to the stigmatization of certain immigrant groups and their resultant social stress. In essence, this law created two categories of immigrants—the "deserving" and the "undeserving"—and exacerbated differences between undocumented and legal immigrants; among different types of legal immigrants; and between legal immigrants and naturalized citizens. Although Congress later restored some benefits to elderly and disabled immigrants and legal immigrant children either already receiving these benefits or in the country at the time of PRWORA’s enactment, this action might have contributed to the idea that some immigrant subgroups are more deserving than others.



Hence the plan:
The United States federal government should repeal Section 434 of the Personal Responsibility and Work Opportunity Reconciliation Act and Section 642 of the Immigration Reform Law to increase access to Medicaid for persons regardless of citizenship status.
The advantage is otherization

Congressional basis for limited access to health care is also used to hunt down immigrants
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229ZE))


B. Federal Limits on Access to Health Care Benefits Congress has enacted a series of laws which severely circumscribed immigrants' access to federal and state government benefits and paved the way for even greater state and local restrictions on health care access for immigrants here legally and illegally. The federal government has also increased scrutiny and enforcement of benefit restrictions, and has increased reporting requirements relating to the status of immigrants seeking emergency and nonemergency health care. 1. Narrowing Eligibility Categories Before 1996, only immigrants who were clearly unauthorized and deportable were denied access to Medicaid benefits.28 An immigrant whose status was ambiguous, under consideration, or even clearly irregular, could still be eligible for government-sponsored benefits.29 However, through the appears that a leading democratic presidential candidate's reform proposals would exclude unauthorized immigrants). Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), Congress narrowed the group of immigrants eligible for federal benefits by treating immigrants of uncertain status more harshly than before.30 Now these groups are treated as undocumented persons who are ineligible for benefits.3' Despite the focus on illegal immigration in the rhetoric surrounding the 1996 legislation, PRWORA also narrowed access for immigrants whose status was clearly legal.32 Prior law had defined eligibility broadly and only excluded narrowly-defined immigrant categories, but PRWORA created a broad rule against access to certain federally-funded public benefits for legal permanent and temporary residents, with exceptions created for certain narrowly defined groups.33 For example, lawful permanent residents are ineligible for most forms of federal benefits; these individuals and foreign-born children who entered the United States legally after 1996 must wait five years to become eligible for federally-funded health services.34 One of the most significant provisions limiting access is not a specific benefit exclusion, but rather the anti-public charge provision in immigration law.35 Sponsors of immigrants are required to sign an affidavit or bond agreement attesting that the sponsor has the means to provide for the immigrant's needs and that the person will not become a public charge.36 This longstanding provision has been seen as an integral part of the immigration law, as officials have frequently relied on this exclusion to deny immigrant and nonimmigrant visas to persons seeking to come to the United States and penalize legalization applicants.37 To determine whether an immigrant is "likely to become a public charge," government officials consider the immigrant's health, age, income, education, skills, and affidavits of support.38 After PRWORA was enacted, officials at the Immigration and Naturalization Service ("INS") began using receipt of public benefits, such as Medicaid, to deny immigrants reentry to the United States or temporary or permanent legal status, unless they repaid these benefits.39 In response to protests from immigrants' rights and health care advocates, the INS stopped this practice and issued a policy stating that the use of health care programs and benefits would not jeopardize immigrants' status or be used to label them a public charge in danger of deportation.40 There are some important exceptions to these restrictions on immigrants' access to care. First, hospitals are required to provide emergency health care for anyone who comes to the emergency room, regardless of immigration status.4' Second, medical care to diagnose and treat communicable diseases is exempted from the ban on access.42 Finally, detainees also have a limited right to health care, which arises from the fact that they have been temporarily deprived of the ability to access care any other way.43 However, despite these standards governing detainee access to care, "no government body is charged with accounting for deaths in immigration detention."4

Fear of attracting immigrant is based on irrational narratives
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229
ZE))

1I. BACKGROUND ON IMMIGRATION DISCOURSE GENERALLY. Before examining the discourse of immigrant health care, it is important to understand the normative underpinnings of immigration control generally, and the justifications for benefit restrictions specifically as means for accomplishing these goals and enforcing these values. A. Immigration Norms One normative justification for immigration control is the necessity of defining a shared culture and for state building.71 By defining conditions of entry or legal status, values for certain behavioral norms are expressed and used to define our culture. For example, professionals who will contribute to our intellectual development and certain refugees seeking asylum may receive preference, but persons who have engaged in conduct that is considered undesirable, such as criminal or politically unpopular activity, are suspect and excluded.72 The ethnic and racial identity of the population is also constructed where national origin, ethnicity, and racial criteria are used covertly or overtly in immigration decisions and enforcement.73 Internal policies affecting the rights and benefits of immigrants while here are viewed as related to these goals if they could undermine immigration criteria and control mechanisms. For example, there are concerns that the prospect of jobs and other economic benefits can lure immigrants here and even encourage them to circumvent legal channels to enter the United States or to overstay visas.74 This concern is fueled by increasing illegal immigration from Mexico and Central America, where the economic disparity with the United States is significant and preventing access across the Mexican border is difficult.75 Even immigrants who come legally may be labeled undesirable if they do not assimilate easily or seem likely to become public charges. This "undesirability" is demonstrated by the fact that, subject to certain narrow exceptions, evidence of self-sufficiency or other private support is an important factor in excluding certain groups.76 Thus, benefit restrictions may be considered part of an overall package of immigration policy which reflects value judgments about the path one takes to come to the United States, as well as who is considered to be worthy and desirable to join American society. Another goal of immigration regulation is to protect the safety and welfare of those who are legal and full-fledged U.S. citizens.7 This goal is closely linked to the behavioral and other criteria used with respect to immigration control discussed above. Excluding or deporting people who are considered dangerous or destabilizing, such as immigrants with criminal backgrounds, is the most obvious example.78 Immigrant utilization of public resources also can trigger these concerns to the extent that it threatens the amount of resources available generally to others in the United States.79 This is especially compelling where the resources are used for health care, education, housing, and other services directly related to ensuring economic stability, physical safety, and good health. Immigrants are often seen as threatening our economic stability and security by stealing our jobs, identities, and scarce public resources.80 Indeed, concerns about roughly one-half of the undocumented persons in the United States were visa overstays."). Illegal immigration tend to rise as economic downturns occur, and immigrants are one of the first groups society and public officials point to as a source of the problem.81 While many immigration-related policies and proposals, including benefit restrictions, are justified primarily on deterrence or distributive justice grounds, there is an increasingly powerful retributive element to them as well. This is reflected most clearly in the Sensenbrenner bill, proposed in 2005, which would have criminalized people here illegally, as well as criminalizing those who provide them aid or support.82 This punitive element is also reflected in the trend of "criminalizing" immigration violations by creating and prosecuting more immigration-related criminal offenses.83 Indeed, a number of people have justified many recent immigration policies, from stricter employment penalties to increasing barriers for getting drivers licenses, on retributivist grounds.84 Benefit restrictions may be viewed in the following light: to the extent benefit restrictions make unauthorized immigrants' lives more difficult while here, they are seen by some as a fitting punishment for those who could avoid this difficulty by choosing to leave.85 The U.S. Supreme Court has even acknowledged the government's right to use benefit restrictions as a type of punishment for those who have chosen to violate our immigration laws: Persuasive arguments support the view that a State may withhold its beneficence from those whose very presence within the United States is the product of their own unlawful conduct ... At the least, those who elect to enter our territory by stealth and in violation of our law should be prepared to bear the consequences, including, but not limited to, deportation.86


Notions of zero-sum resources allow policymakers to blindly blame immigrants for the health care crisis. This forces us to de-prioritize immigrants in society by restricting their benefits
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229ZE))


B. Benefit Restrictions are Necessary to Protect Our Health Care Resources. Health care benefit restrictions are also justified on distributive justice grounds. Restrictionists create a framework for discourse that assumes resource allocation decisions are a zero-sum proposition, where granting access to one person, necessarily means depriving someone else."' This paradigm forces us to prioritize different groups' rights to access health care. Immigration status becomes an easy basis for linedrawing as citizens are viewed as more deserving and with a stronger claim to healthcare benefits than immigrants, especially unauthorized immigrants. 12 This need for prioritizing claims in ways that exclude immigrants becomes more compelling as one considers the current healthcare financing crisis and the dwindling supply of quality healthcare providers. Healthcare financing is critical for people to be able to access care and for healthcare professionals and facilities to continue to operate and provide necessarycare. Our current system provides public health insurance only to select groups: the poorest children and their parents (including pregnant women), the disabled, elderly, and government employees and veterans.13 We rely on private insurance, primarily through employment, to cover the rest of society."14 However, employers are not required to provide coverage and increasingly employers are either offering coverage at a cost that is too high for the employees to afford or choosing not to offer coverage at all.'5 In the individual insurance market, insurance companies have so much discretion that the individuals who are most in need of insurance are often priced out of the market, leaving millions of people in the United States uninsured."16 Shrinking financial resources also affect the ability and willingness of quality providers to serve communities with the greatest need. Growing numbers of uninsureds and declining reimbursement rates have led to nursing and physician shortages in hospitals, especially in emergency rooms.117 It has also led to a financial strain causing many public and private hospital closures and relocations to more affluent communities."l8 While these shortages occur disproportionately in areas with lower socioeconomic status, higher minority populations, and high need, they can create a cascade effect that increases the burden on remaining hospitals which must absorb these patients."9 In essence, limited healthcare financing and a dwindling healthcare safety net mean that many people are vying for ever-shrinking resources.'20 It is against this backdrop of a financial crisis that a picture is created of immigrants as a threat to the already fragile health system on which citizens currently depend.'12 Indeed, the mere presence of immigrants who are not entitled to be here or who are admitted on the condition that they not become public charges, seems to threaten public resources, because many immigrants are uninsured122 and are more likely to serve in dangerous jobs with an increased likelihood of workplace injury or illness.123 For example, one article by the Center for Immigration Studies, known for advocating immigration control and reduction, highlighted these concerns.124 The Center for Immigration Studies reported that 30% of all immigrants and their children lack health insurance and receive some kind of public assistance, while immigrant families account for almost 75% of the increase in the uninsured in the past fifteen years. 125 The picture of immigrants as an economic drain is reinforced with statistics about the cost of hospital care for undocumented immigrants. For example, the L.A. Times quoted an estimated annual cost of $200 million for facilities in California, Arizona, New Mexico, and Texas and described the cost as "staggering."'26 Restrictionists have blamed the financial crisis in health care on unauthorized immigrants, predicting that care for unauthorized immigrants will force hospitals already on the verge of bankruptcy to close their doors.' 27 Recently, the argument has shifted to a more imminent, direct healthcare threat in the form of hospital emergency room closures. Hospital closures are the most visible example of the implications of shrinking healthcare resources and the implications for our health. Rates of hospital closures have exploded in the last decade, especially public hospitals and hospitals treating a high proportion of uninsured patients.128 As hospitals close, remaining hospital emergency rooms become overcrowded and qualified physicians often refuse to serve on-call or they leave the community altogether, thereby jeopardizing access and quality of care for everyone.'29

This public discourse shapes an “Us-Them” dichotomy
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229
ZE))

B. Dominant Narrative. The dominant picture in our media and public discourse is created by those lamenting illegal immigration and emphasizing immigration control. A number of scholars have identified that the general immigration discourse creates an "Us-Them" dichotomy and labels immigrants as "outsiders" or "others" in ways that fuel misunderstanding, fear, and mistrust.87 Scholars have also documented that in immigration discourse, a vivid picture is painted of "the illegal immigrant" whom we should fear, punish, and exclude.88 The stereotypical symbol in the discourse has been a male immigrant from Mexico or somewhere in Central America who comes to the United States through deceptive and illegal means, or comes legally, but then overstays his visa only to "disappear" into society in violation of the terms of the visa.89 Immigrants are seen as a threat to our culture if they fail to assimilate and demand special accommodations for their language difference in schools, hospitals, and the workplace.90 These concerns are probably further exacerbated by a change in the stereotypical profile of illegal immigrants to Mexican women who come here to give birth to children.91 These children, though technically U.S. citizens if born here, are still socially and culturally labeled as outsiders who are benefitting from a moral and legal wrong, and thus not truly accepted.92 Immigrants are also painted as dangerous and a threat to our safety.93 Certainly, this tendency is heightened after a major terrorist attack or national security threat.94 However, we also see this trend among Hispanic immigrants, as growing numbers of unauthorized immigrants come from Mexico and Central America.9" Stories of violent criminal activity by immigrants from these areas create an image of the "dangerous immigrant."96 The terms "illegals" and "illegal aliens," used to describe immigrants residing in the United States in violation of immigration law, also reinforce this picture by putting unauthorized immigrants on the same footing as other criminals in our society. In fact, much of the immigration rhetoric mirrors language used in talking about domestic criminal policies. For example, some presidential candidates try to distinguish themselves by claiming to be "tough on illegal immigrants" in the same way that state and local politicians claim to be "tough on crime.97 The mere act of coming here through improper channels or violating some condition of legal status taints every other activity of the immigrant while here. Unauthorized immigrants are seen as criminals who come to steal jobs, education, and benefits.98 Immigrants who need public assistance are viewed even harsher: they are labeled not only as criminals, but as welfare abusers, who steal from the most vulnerable and needy among our citizens.99

We use “others” to define us and our actions—perception of dangerous “others” is the root cause of war
Christopher Rudolph. 2006 National Security and Immigration: Policy Developments in the United States and Western Europe Since 1945. Stanford, CA: Stanford University Press.


In the early 1990s, Myron Weiner argued that the features of population movement “suggest the need for a security/stability framework for the study of international migration that focuses on state policies toward emigration and immigration as shaped by concerns over internal stability and international security” ' The present book attempts to do just that by simultaneously addressing two central questions: (1) What role does international migration and border control play in national security? (2) How do security interests affect the timing and form of immigration and border control policies? Although sizeable literatures have been developed on the issues of security (primarily political scientists and historians) and immigration (in social sciences, humanities, and law), these have, for the most part, proceeded along largely separate paths. Only recently has scholarship begun exploring the relationship between the two.2 The purpose of this book is to illustrate the important linkages that exist between national security and international migration, and perhaps more importantly, to establish the first steps in theorizing state behavior that stems from this interaction. A More Comprehensive Framework of Security» “National security" has generally been defined in very limited terms, consisting primarily of issues related to interstate military conflict. As the post- cold war environment presents a more complex security system, we are beginning to see new thinking about security that is better able to more accurately capture the new dynamics at play in world politics. Barry Buzan argues, “Understanding the national security problem requires a wide-ranging understanding of the major levels of analysis and issue sectors that comprise the field of International Studies. Although the term ‘national security’ suggests a phenomenon on the state level, the connections between that level and the individual, regional and systems levels are too numerous and too strong to deny.” 3Some security scholars may be reluctant to embrace the more comprehensive and complex characterizations of security because they threaten the orthodox view that the realm of "high politics" must remain distinct from the realm of “low politics.” The security paradigm proposed herein is intended to provide a theoretical framework that allows some sense of how "high" and “low" politics are in many ways interdependent. Although they may exist in an anarchic global system, nations are not always in a state of conflict. We are then left with an important question: What drives politics when geopolitical (military) threats decline? Constraining our thinking about security solely within the domain of “high politics” provides no tools to address this question. The theoretical framework offered in this book provides a means to identify both external and internal facets of security, and to explore the relationships between them. Taken together, the Threat and Rally Hypotheses provide a rationale for Why societal security interests decline in relative importance in the formation of state grand strategy when geopolitical military threats are acute, and also how and why these priorities change as the Still cultural environment shifts over time. The framework provides a means to accurately describe, and perhaps predict, the changing priorities of grand strategy that emphasize some combination of external and internal security interests. It also illustrates how the geopolitical security environment can shape national identity. Some critics have suggested that the concept of “societal security" is flawed because it imposes a rigid, "near positivist" view of identity on society: "Identity is not a fact of society; it is a process of negotiation among people and interest groups.”‘* The concept is not utilized in this fashion within the context of the framework offered herein-in fact, it is quite the opposite. What is important to recognize in questions regarding national identity is that, even though it may, in fact, be in a continuous state of flux: as a result of public deliberation, it is rare (I would argue, nonexistent) that proponents of any particular type of national identity receive of it in such fluid terms. Rather, individuals and groups simply have competing views of a largely static conceptualization- or are arguing for the replacement of an existing dominant idiom to be replaced with a new dominant, largely static concept. For example, the ethno-nationalist rhetoric of social conservatives in France, such as Jean-Marie Le Pen, conceives of an enduring French society based largely on issues of ethnicity and culture. In contrast, social liberals staunchly defend the civic-nationalist concept of lai-cité and have passed laws restricting religious dress in public schools in order to maintain continuity of a national identity conceived of in terms of ideology and common interests. Each has an idealized vision of French nation-hood that provides an enduring sense of purpose, place, and meaning. Even though contrary and conflicting conceptions of nationhood may be present in a society, a dominant idiom of national identity can be identified at a given point of time and may remain dominant across a given period. When examining internal, “societal security" interests, this does not suggest that a dominant idiom is presupposed—reifying it as an object of security. Rather, it suggests that policymakers are responsive to perceptions of the dominant national identity, may also influence popular conceptions of national identity by leading public discourse, and are compelled to respond to threats against this identity with new policy. Even though national identity may be evolving over time, societal security interests are reflected in policy outcomes at specific points in time. The available empirical evidence suggests that these dynamics are applicable to both generally civic-oriented nations, such as the United States, France, and Great Britain, and generally ethnic-oriented nations, such as Germany. Although national identity is often conceived in primordial terms that presuppose enduring qualities over time, the empirical evidence presented herein suggests that conceptions of nationhood—in terms of deciding

Rudolph continues…
Rudolph continues…


who “we" are—can be affected by the presence or absence of an external enemy as well as other elements of the structural environment, including patterns of international migration. Samuel Huntington argues, "To define themselves, people need an other.” Extending this logic to society writ large, he adds, "National unity is enhanced as potentially divisive internal antagonisms are suppressed in the face of a common enemy.”’ Clearly, we can expect an increased likelihood of the opposite effect when external enemies decline. Many policymakers are keenly aware of these social dynamics and the "energizing force” that external enemies can have on internal social cohesion.‘ As the cold war drew to a close, an advisor to Soviet leader Mikhail Gorbachev remarked, "We are doing something really terrible to you—we are depriving you of an enemy." Patterns of international migration can also challenge conceptions of national identity, depending on the volume and compositiion of flows. As the available evidence makes clear, large-scale immigration flows can have a profound effect on social demographics in receiving countries, and this effect can be magnified if immigrant birthrates are significantly higher than the native population, as is the case in the United States and Western Europe.


Non-citizens become threats to the system—we wage perpetual war against the “other”
(Lauren Wilcox, New Hampshire politics, 2003 (The New Hampshire Institute of Politics, “Security Masculinity.”
http://www.anselm.edu/NR/ rdonlyres/584EAD25-FDAD-484B- AFA9-F8709DBB41FD/1242/ Article20033.pdf)


The securitization of immigration has intensified since September 11th. In late October of 2001, President Bush stated, “The American people are beginning to understand that we fight a two-front war against terror.”28 This statement is meant to convey that the War on Terror involves not only military operations overseas, but militaristic strategies to cope with the dangers of terrorism in the United States as well. The ‘second front’ of operations is focused on controlling the borders of the United States. The moral of the story of September 11th seems to be a lesson about the dangers of allowing ‘foreigners’ into the country. Increasing border controls became a relatively uncontroversial and widely supported means of preventing future terrorism.29 The securitization and subsequent militarized approach to immigration was solidified with the creation of the National Security Entry-Exit Registration System. To introduce this system, Attorney-General John Ashcroft proclaimed its necessity by equating immigrants (potential terrorists) to a foreign army living among us: In this new war, our enemy’s platoons infiltrate our borders, quietly blending in with visiting tourists, students, and workers. They move unnoticed through our cities, neighborhoods, and public spaces. They wear no uniforms. Their camouflage is not forest green, but rather it is the color of common street clothing. Their tactics rely on evading recognition at the border and escaping detection within the United States. Their terrorist mission is to defeat America, destroy our values and kill innocent people.30 The Nation Security Entry-Exit Registration System contains a database of fingerprints from ‘known terrorists’ that can be used to check against persons attempting to enter the United States. It also involves registering persons from countries of ‘elevated national security concern,’ which includes almost all of the Middle Eastern and North African states and a few Asian countries with large Muslim populations such as Pakistan and Indonesia. Finally, the system entails sending information, photographs, and fingerprints of immigrants who have overstayed their visa, or are not compliant with visa requirements to the National Crime Information System so that they may be apprehended when stopped by the police for other violation, such as in traffic stops. This system specifically targets persons from these countries, subjecting them to greater scrutiny and surveillance than the rest of the immigrant population, with a greater risk of detainment and deportation. That immigration is now being treated as a matter of national security is suggested by the use of these surveillance and other technologies in the process of deciding who to allow into the United States. The creation of vast databases of information about immigrants designed to be quickly accessible to consular staff, border patrols, and law enforcement is one manifestation of the securitization of immigration. Furthermore, biometric information about visa applicants will soon be collected.31 Agencies of the Immigration and Naturalization Services (INS), the Coast Guard, the Border Patrol, the Customs Service have been reorganized into the Department of Homeland Security. This shift combines agencies that deal with immigration into the same department as law enforcement agencies. Secretary of State Colin Powell, in the summer of 2002, noted to the House Select Committee on Homeland Security, As you know, our first line of defense in protecting ourselves from those who would come to our shores are our diplomats at our consulates and other location around the world, where we issue visas to people to come to America. The United States is ready to make sure that our visa system is a strong one, a secure one, but at the same time, one that encourages people to come to the Untied States, once we have made sure that they are the right kinds of people to come into our nation, they are not coming in to conduct any kind of activity which would be injurious to any American.32 This statement not only suggest the securitization of immigration, but also the nature of this process as being based on a certain idea of national identity, in which the government has the power to determine who are ‘the right kinds of people’ who are to be allowed in (with special scrutiny towards persons from Northern African and Middle Eastern states). The connection between immigration and security is not obscure; in fact, the issue of immigration can be crucial to securitization, as it is “linked to the loss of a control narrative that associates the issues of sovereignty, borders, and both internal and external security.”33 Identity and Securitization As David Campbell argues, security and identity are inextricably linked; what constitutes a security threat creates what is defined as the identity of a nation. “A notion of who/what ‘we’ are is intertwined with an understanding of who/what ‘we’ are not and who/what ‘we’ fear….”34 Thus, the ‘dangers’ that threaten ‘us’ and our identity are located not only geographically outside of the nation, but are outside of the national system of values and identity. They are, in fact, the antithesis of what ‘we’ are. Simultaneously to process of securitizing terrorism, definitions of American identity were advanced. During the State of the Union speech in January of 2002 and elsewhere, Bush defined what he believed to be the character of America and its core values, especially in opposition to those of the terrorists. It should be noted that this is a mere sampling of many similar statements made by President Bush as well as many other top government officials and commentators. During the past few months, I’ve been humbled and privileged to see the true character of this country in a time of testing. Our enemies believed America was weak and materialistic, that we would splinter in fear and selfishness. They were as wrong as they are evil. We have a great opportunity during this time of war to lead the world toward the values that will bring lasting peace. America will always stand firm for the non-negotiable demands of human dignity: the rule of law; limits on the power of the state; respect for women; private property; free speech; equal justice; and religious tolerance. Deep in the

Wilcox continues…
Wilcox continues…


American character, there is honor, and it is stronger than cynicism. Our enemies sent other people’s children on missions of suicide and murder. They embrace tyranny and death as a cause and a creed. We stand for a difference choice, made long ago, on the day of our founding. We choose freedom and the dignity of every life.35 There is a value system that cannot be compromised, and that is the values that we praise. And if the values are good enough for our people, they ought to be good enough for others, not in a war to impose because these are God-given values. These aren’t United Statescreated values. These are values of freedom and the human condition and mothers loving their children.36 Ours is a country based upon tolerance… And we’re not going to let the war on terror or terrorists cause us to change our values.37 In pursuit of our goals, our first imperative is to clarify what we stand for: the United States must defend liberty and justice because these principles are right and true for all people everywhere.38 In the war against global terrorism, we will never forget that we are ultimately fighting for our democratic values and way of life. Freedom and fear are at war.39 The characteristics we most cherish—our freedom, our cities, our systems of movement and modern life—are vulnerable to terrorism.40 In all of these statements, President Bush defines American values and identity in very stark terms. Strength, freedom, liberty, justice, dignity of life, rule of law, rights of women, modernity, tolerance and private property are all ‘American’ values. The enemy, the terrorists, stand for the exact opposite: evil, tyranny, death, anarchy, oppression of women, fear, backwardness and barbarism. This discourse sets up clear, normative, distinctions between ‘us’ and the ‘terrorists,’ making it easy to marginalize, vilify and dehumanize not only ‘terrorists,’ but also all those associated with these characteristics of terrorism. By demarcating the boundary between an ‘inside’ of Americans and American values, and an outside of foreigners and ‘un-American’ values, making borders more closed to immigrants follows logically. Throughout American history, immigration policy has been based upon supposed threats to American culture and societal cohesion, and has served to keep out ‘undesirables.’41 The securitization of immigration is especially important in defining American identity, as “migration is at the focal point of the interrelated dynamics of identity, borders, and orders.”42 In September of 2002, reporter Michelle Malkin published Invasion: How America Still Welcomes Terrorists, Criminals, and Other Foreign Menaces to Our Shores, with the overarching theme that immigration must be treated as a national security problem. Her rationale goes beyond the fact that the perpetrators of the September 11th attacks were foreign nationals, as her book details stories of immigrants, both legal and illegal, who murdered police officers and innocent people, dealt drugs and were involved in other instances of political violence. Immigrant communities, not just the immigrants who are ‘terrorists’ per se have also been blamed for the terrorist attacks, because large populations of un-assimilated immigrants (from Islamic countries, in this discourse) can make it easier for a terrorist to blend in. As one columnist argued, “The Sept. 11 attacks have made change a much graver matter. Cuts in legal immigration would contribute to improved security by permitting more efficient management and by denying terrorist cover.”43 As noted from Ashcroft’s statement on the Nation Security Entry-Exit Registration System, immigrants are a threat because they are able to blend in and move unnoticed. This is due to the very fact that there are significant populations of relatively unassimilated immigrants, denoting all immigrants as potential threats, either as terrorists, or for their mere presence that obscures the presence of more ‘outsiders’. Overall, the consequence (or perhaps intention) of the securitization of immigration has been to associate immigration and immigrants with discourses of threats and danger not only as terrorists threatening our physical safety but our culture and way of life.

Excluding immigrants in health care dehumanizes them by labeling them as “undeserving”
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229ZE))


Certainly equating Mexican with "illegals" is problematic as a factual and policy matter, and it is not clear from this comment whether the author would support or oppose coverage for unauthorized immigrants in light of his apparent concern about overcrowded emergency rooms. This story is useful, however, in demonstrating the extent to which the very presence of unauthorized immigrants is viewed as life threatening because of disruptions to emergency care access in the discourse of immigrant health care. These concerns assume a choice between "us" or "them." The numbers of uninsured citizens are compared to uninsured, unauthorized immigrants in need of health care to trigger a public fear that "they" will use up our resources and that none will be left for "us.'31 In fact, the executive vice president of the Hospital Association of Southern California described the Nextcare "transfers" to Mexico as "a responsible and inventive way of dealing with a shortage of beds for indigent patients" for border states and counties that are "tired of waiting for the federal government to deal with this problem."'132 In other words, hospitals, as well as state and local governments, are in the position of making unfortunate, but necessary, choices about which people will receive scarce healthcare resources. C. Benefit Restrictions as Punitive for Violations of the Social Contract At one level, there is a punitive aspect to the distributive justice justifications for benefit restrictions. The linedrawing done in this area has typically been based on economic and medical need, as well as on notions of who is deserving. In order for people to have a legal claim to scarce healthcare resources, they must demonstrate some compelling need and reason for the special entitlement. In the case of health insurance, unlike many other social service programs, the "benefit" is access to health care, not money. This "benefit" will always be limited by need-healthcare insurance will only pay for medically necessary care, and even then it does not pay for every type of necessary care. Moreover, when talking about the groups who are vying for Medicaid benefits, the discussion turns to people who demonstrate clear economic need, both because of their low income and failure to secure private insurance. Thus, exclusions of immigrants who otherwise fit these criteria are viewed primarily on grounds of "dessert" and the fact that they are "undeserving" of government-funded health care. This retributive element is most powerful in two proposals that have not gained much traction politically, but nonetheless have sent a clear message to immigrants. The first is a proposal to deny U.S. citizenship to the children of unauthorized immigrants' in order to exclude them from public health insurance, which punishes citizen children for their mothers' immigration violations.133 The second is Bush's proposal to require hospital officials to report undocumented immigrants' status to immigration authorities. Such reporting requirements are viewed by immigrants as penalties for seeking health care.134 These sentiments are also expressed widely among popular discussions by people angry about the rights given to U.S.-born children of unauthorized immigrants and in statements that hospitals should facilitate the deportation of unauthorized immigrants. 135 This retributive rhetoric has focused on "illegal" immigrants viewed as "undeserving" because of their status. In popular commentary, exclusions are described as necessary punishment for immigrants who would otherwise benefit from their illegal activity and are labeled as fair because unauthorized immigrants always have the choice to leave to avoid the policy's harsh effects.136 Indeed, we often hear people who favor tough immigration policies as distinguishing themselves as being against "illegal immigration," not anti-immigrant, in order to emphasize the element of culpability among unauthorized immigrants that justifies differential and harsher treatment. 137

This marginalization of populations makes global annihilation inevitable
Etienne Balibar Emeritus Professor of Philosohy at University of Paris 2004 ALSO X and Distinguished Professor of Humanities at University of California-Irvine, We, The People of Europe? Reflections on Transnational Citizenship, p. 126-29


I am aware of all these difficulties, but I would maintain that a reality lies behind the notion of something “unprecedented.” Perhaps it is simply the fact that a number of heterogeneous methods or processes of extermination (by which I mean eliminating masses of individuals inasmuch as they belong to objective or subjective groups) have themselves become “globalized,” that is, operate in a similar manner everywhere in the world at the same time, and so progressively form a “chain,” giving full reality to what E. P. Thompson anticipated twenty years ago with the name “exterminism.”’3 In this series of connected processes, we must include, precisely because they are heterogeneous—they do not have one and the same “cause,” but they produce cumulative effects: 1. Wars (both “civil” and “foreign,” a distinction that is not easy to draw in many cases, such as Yugoslavia or Chechnya). 2. Communal rioting, with ethnic and/or religious ideologies of “cleansing.” 3. Famines and other kinds of “absolute” poverty produced by the ruin of traditional or nontraditional economies. 4. Seemingly “natural” catastrophes, which in fact are killing on a mass scale because they are overdetermined by social, economic, and political structures, such as pandemics (for example, the difference in the distribution of AIDS and the possibilities of treatment between Europe and North America on one side, Africa and some parts of Asia on the other), drought, floods, or earthquakes in the absence of developed civil protection. In the end it would be my suggestion that the “globalization” of various kinds of extreme violence has produced a growing division of the “globalized” world into life zones and death zones. Between these zones (which indeed are intricate and frequently reproduced within the boundaries of a single country or city) there exists a decisive and fragile superborder, which raises fears and concerns about the unity and division of mankind—something like a global and local “enmity line,” like the “amity line” that existed in the beginning of the modern European seizure of the world.’4 It is this superborder, this enmity line, that becomes at the same time an object of permanent show and a hot place for intervention but also for nonintervention. We might discuss whether the most worrying aspect of present international politics is “humanitarian intervention” or “generalized nonintervention,” or one coming after the other. Should We Consider Extreme Violence to Be “Rational” or “Functional” from the Point of View of Market Capitalism (the “Liberal Economy”)? This is a very difficult question—in fact, I think it is the most difficult question—but it cannot be avoided; hence it is also the most intellectually challenging. Again, we should warn against a paralogism that is only too obvious but nonetheless frequent: that of mistaking consequences for goals or purposes. (But is it really possible to discuss social systems in terms of purposes? On the other hand, can we avoid reflecting on the immanent ends, or “logic,” of a structure such as capitalism?) It seems to me, very schematically, that the difficulty arises from the two opposite “global effects” that derive from the emergence of a chain of mass violence—as compared, for example, with what Marx called primitive accumulation when he described the creation of the preconditions for capitalist accumulation in terms of the violent suppression of the poor. One kind of effect is simply to generalize material and moral insecurity for millions of potential workers, that is, to induce a massive proletarianization or reproletarianization (a new phase of proletarianization that crucially involves a return of many to the proletarian condition from which they had more or less escaped, given that insecurity is precisely the heart of the “proletarian condition”). This process is contemporary with an increased mobility of capital and also humans, and so it takes place across borders. But, seen historically, it can also be distributed among several political varieties: 1. In the “North,” it involves a partial or deep dismantling of the social policies and the institutions of social citizenship created by the welfare state, what I call the “national social state,” and therefore also a violent transition from welfare to workfare, from the social state to the penal state (the United States showing the way in this respect, as was convincingly argued in a recent essay by Loic Wacquant).’5 2. In the “South,” it involves destroying and inverting the “developmental” programs and policies, which admittedly did not suffice to produce the desired “takeoff’ but indicated a way to resist impoverishment. 3. In the “semiperiphery,” to borrow Immanuel Wallerstein’s category, it was connected with the collapse of the dictatorial structure called “real existing socialism,” which was based on scarcity and corruption, but again kept the polarization of riches and poverty within certain limits. Let me suggest that a common formal feature of all these processes resulting in the reproletarianization of the labor force is the fact that they suppress or minimize the forms and possibilities of representation of the subaltern within the state apparatus itself, or, if you prefer, the possibilities of more or less effective counterpower. With this remark I want to emphasize the political aspect of processes that, in the first instance, seem to be mainly “economic.” This political aspect, I think, is even more decisive when we turn to the other scene, the other kind of result produced by massive violence, although the mechanism here is extremely mysterious. Mysterious but real, unquestionably. I am thinking of a much more destructive tendency, destructive not of welfare or traditional ways of life, but of the social bond itself and, in the end, of “bare life.”’6 Let us think of Michel Foucault, who used to oppose two kinds of politics: “Let live” and “let die.”’7 In the face of the cumulative effects of different forms of extreme violence or cruelty that are displayed in what I called the “death zones” of humanity, we are led to admit that the current mode of production and reproduction has become a mode of production for elimination, a reproduction of populations that are not likely to be productively used or exploited but are always already superfluous, and therefore

Balibar continues…
Balibar continues…


can be only eliminated either through “political” or “natural” means—what some Latin American sociologists provocatively call poblacion chatarra, “garbage humans,” to be “thrown” away, out of the global city.’6 If this is the case, the question arises once again: what is the rationality of that? Or do we face an absolute triumph of irrationality? My suggestion would be: it is economically irrational (because it amounts to a limitation of the scale of accumulation), but it is politically rational—or, better said, it can be interpreted in political terms. The fact is that history does not move simply in a circle, the circular pattern of successive phases of accumulation. Economic and political class struggles have already taken place in the nineteenth and twentieth centuries with the result of limiting the possibilities of exploitation, creating a balance of forces, and this event remains, so to speak, in the “memory” of the system. The system (and probably also some of its theoreticians and politicians) “knows” that there is no exploitation without class struggles, no class struggles without organization and representation of the exploited, no representation and organization without a tendency toward political and social citizenship. This is precisely what current capitalism cannot afford: there is no possibility of a “global social state” corresponding to the “national social states” in some parts of the world during the last century. I mean, there is no political possibility. Therefore there is political resistance, very violent indeed, to every move in that direction. Technological revolutions provide a positive but insufficient condition for the deproletarianization of the actual or potential labor force. This time, direct political repression may also be insufficient. Elimination or extermination has to take place, “passive,” if possible, “active” if necessary; mutual elimination is “best,” but it has to be encouraged from outside. This is what allows me to suggest (and it already takes me to my third question) that if the “economy of global violence” is not functional (because its immanent goals are indeed contradictory), it remains in a sense teleological: the “same” populations are massively targeted (or the reverse: those populations that are targeted become progressively assimilated, they look “the same”). They are qualitatively “deterritorialized,” as Gilles Deleuze would say, in an intensive rather than extensive sense: they “live” on the edge of the city, under permanent threat of elimination; but also, conversely, they live and are perceived as “nomads,” even when they are fixed in their homelands, that is, their mere existence, their quantity, their movements, their virtual claims of rights and citizenship are perceived as a threat for “civilization.” In the End, Does “Extreme Violence” Form a “Global System”? Violence can be highly “unpolitical”—this is what I wanted to suggest— but still form a system or be considered “systematic” if its various forms reinforce each other, if they contribute to creating the conditions for their succession and encroachment, if in the end they build a chain of “human(itarian) catastrophes” where actions to prevent the spread of cruelty and extermination, or simply limit their effects, are systematically obstructed. This teleology without an end is exactly what I suggested calling, in the most objective manner, “preventive counterrevolution” or, better perhaps, “preventive counterinsurrection.” It is only seemingly “Hobbesian,” since the weapon used against a “war of all against all” is another kind of war (Le Monde recently spoke about Colombia in terms of “a war against society” waged by the state and the Mafiosi together).’9 It is politics as antipolitics, but it appears as a system because of the many connections between the heterogeneous forms of violence (arms trade indispensable to state budgets with corruption; corruption with criminality; drug, organ, and modern slave trade with dictatorships; dictatorships with civil wars and terror); and perhaps also, last but not least, because there is a politics of extreme violence that confuses all the forms to erect the figure of “evil” (humanitarian intervention sometimes participates in that), and because there is an economics of extreme violence, which makes both coverage and intervention sources of profitable business. I spoke of a division between zones of life and zones of death, with a fragile line of demarcation. It was tantamount to speaking of the “totalitarian” aspects of globalization. But globalization is clearly not only that. At the moment at which humankind becomes economically and, to some extent, culturally “united,” it is violently divided “biopolitically.” A politics of civility (or a politics of human rights) can be either the imaginary substitute of the destroyed unity, or the set of initiatives that reintroduce everywhere, and particularly on the borderlines themselves, the issue of equality, the horizon of political action.

Benefit restrictions for immigrants establish a system of violence and justify racism
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229
ZE))

Proponents of benefit restrictions tell a story that clearly reinforces an "Us-Them" dichotomy and the dominant immigrant narrative in immigration discourse. Immigrants who are here illegally are viewed as having a parasitic and unhealthy relationship with the United States. They are viewed as criminals, who steal public money from vulnerable and morally deserving citizens and who consequently threaten citizens' health and safety. Immigrants here legally are not as visible in this picture. They are usually lumped in with undocumented immigrants, probably because they are also viewed as welfare abusers who are violating the social contract that demands self-sufficiency and are threatening the availability of resources for citizens, who are viewed as having a stronger moral and legal claim to public benefits. The dominant narrative also tells a story about "us" as American citizens. Essentially, the following picture is painted: the United States is acting out of necessity to preserve resources and protect the health and welfare of its citizens. To the extent immigrants suffer from our laws and policies, our policies are morally justified because we are endangered by the choice of unauthorized immigrants to stay in the United States. Finally, we actually treat immigrants, even unauthorized immigrants, with empathy and beneficence by creating certain exceptions granting them health care access in extremely vulnerable situations where they have no control, such as for emergency care, care for immigrants seeking asylum, or victims of domestic violence. At one level, pro-access rhetoric seeks to challenge the dominant narrative by painting a very different picture of immigrants excluded from the U.S. healthcare system. However, a closer look shows that some of this rhetoric unintentionally reinforces the dominant picture of immigrants and refines the narrative of our motivations in ways that could potentially undermine the pro-access advocates' rhetorical, political, and legal goals. A. Immigrants: Iconic Victims or Vectors of Disease? Essentially, through the pro-access discourse, critics attempt to challenge much of the dominant narrative by cultivating the picture of immigrants as a vulnerable group that, despite their many contributions to our economy, live in fear and under dangerous conditions. Immigrants are afraid to use a healthcare system perceived as a hostile, de facto agent of immigration authorities, even when they are legally entitled to care. Many of these immigrants represent innocent people falling through the gaps of a labyrinthine and backlogged immigration system and a so-called healthcare safety net with massive holes. Immigrants whose status is legal or uncertain, as well as immigrant and citizen children are among those affected. Benefit restrictions coupled with heightened enforcement and data collection by hospital officials create a system in which many immigrants are being victimized through fear, racial profiling, and denial of care when they are most in need. The ability to transform the dominant narrative, however, is constrained by arguments challenging benefit restrictions along distributive justice grounds. These arguments assert that, rather than protecting citizens, such restrictions harm citizens by erecting additional barriers to care, further straining our healthcare resources, and creating a public heath danger. Denial of access for some groups can also harm the rest of society directly or indirectly. This line of rhetoric, especially the paradigm of health care as a public good, seems designed to create a picture of everyone (citizens and noncitizens) being interconnected in significant ways that challenge the "Us-Them" dichotomy. However, this narrative also can be seen as having serious negative effects, reinforcing part of the dominant paradigm used to justify benefit restrictions. The most obvious rhetorical effect is that it can feed into the narrative of the dangerous immigrant who threatens citizens' economic and physical security. This is probably clearest in the public health justification used to challenge benefit restrictions. Health and legal advocates, as well as law reviews, consistently begin with this fear-based argument: a fear of what will happen if we do not encourage access.182 Indeed, the few law review pieces that focus on healthcare restrictions for immigrants often begin with some dire warning that fuels this fear.'83 This is also present in claims about dwindling economic resources and the indirect financial consequences of denying immigrants' care. People on both sides of the debate frequently discuss threats to our current healthcare resources, encouraging the public's fear of growing use of emergency services by immigrants and other uninsured.184 Both seem to use the public's fear to shape policy; the difference, however, is that pro-access advocates offer a different solution to this crisis that requires expanded access to health care. Playing into these fears of dwindling resources can unfortunately reinforce the "Us-Them" dichotomy by determining our treatment of immigrants based on what we want for ourselves-not based on ethical or moral norms about how they should be treated. This is reminiscent of the justifications first used to provide health care to slaves and then newly freed blacks. The first system of "managed care" was health care provided to slaves by plantation owners to ensure their continued productivity.'85 Once free, blacks were still largely excluded from the healthcare system until physicians successfully argued that this created a public health danger to whites-especially in the area of communicable diseases.86 In Health Care Divided: Race and Healing a Nation, David Barton Smith criticized this approach on several grounds, noting that this essentially reduced blacks merely to "vectors of disease" that needed to be cleansed and made safe for others.'87

Racism makes the extinction impacts are inevitable—it’s try or die
(Joseph Barndt, 2007, Understanding & Dismantling Racism: the twenty-first century challenge to white America, p.219-220)


To study racism is to study walls. In every chapter of this book, we have looked at barriers and fences, restraints and limitations, ghettos and prisons, bars and curtains. We have examined a prison of racism that confines us all—people of color and white people alike. Victimizers as well as victims are in shackles. The walls of the prison forcibly separate communities of color and white communities from each other, as well as divide communities of color from each other. In our separate prisons we are all shut off from each other. The constraints imposed on people of color by subservience, powerlessness, and poverty are inhuman and unjust; but the effects of uncontrolled power, privilege, and greed that are the marks of our white prison inevitably destroy white people as well. To dismantle racism is to tear down walls. The walls of racism can be dismantled. We are not condemned to an inexorable fate, but are offered the vision and the possibility of freedom. Brick by brick, stone by stone, the prison of individual, institutional, and cultural racism can be destroyed. It is an organizing task that can be accomplished. You and I are urgently called to join the efforts of those who know it is time to tear down, once and for all the walls of racism. The walls of racism must be dismantled. Facing up to these realities offers new possibilities, but refusing to face them threatens yet greater dangers. The results of centuries of national and worldwide colonial conquest and racial domination, of military buildups and violent aggression, of over-consumption and environmental destruction may be reaching a point of no return. The moment of self-destruction seems to be drawing ever more near, nationally and globally. A small and predominantly white minority of the global population derives its power and privilege from the sufferings of the vast majority of peoples of color. For the sake of the world and ourselves, we dare not allow it to continue. Dismantling racism also means building something new it means building an antiracist society. The bricks that were used to build the walls of the prison must now be used for a better purpose. Just as we must tear down the wall brick by brick, so also we must build new structures of power and justice. Although we still need many more reminders that we cannot build a multiracial and multicultural society without tearing down the walls of racism, this negative reminder must be turned around and stated in reverse: we cannot tear down the walls without building new antiracist structures of power in our institutions and communities. Transforming and building anti-racist institutions is the path to a racism-free society.

Contention 2 is solvency
Congressional Repealing of Section 434 of PRWORA and Section 642 of the Immigration Reform Law is critical to letting immigrants access healthcare
Park, Associate of Troutman Sanders LLP, ’04
(
Seam, J.D., Substantial Barriers in Illegal Immigrant Access to Publicly-Funded Health Care: Reasons and Recommendations for Change”, Georgetown Immigration Law Journal, Volume 18, Issue 3, Spring 2004, Lexis, [Abhik])


The first, and most essential step of the recommendation process requires Congress to repeal Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law. This step is of vital importance because these sections have created an indirect roadblock for illegal immigrants accessing federally or state funded health care because they are not shielded from having their immigration status reported to the INS by health care officials. Repealing this legislation is the touchstone of providing illegal immigrants with undeterred publicly funded health care because if these sections remain in existence, states will not have the ability to provide illegal immigrants with security when they choose to access the available federally funded care and nor will states be effectively granted the power to provide illegal immigrants with preventive care. Congress should not have a problem repealing these sections because the [*586] objectives behind this legislation are unjustifiable. n123 Legislation proposing the reporting of immigration status of illegal immigrants when they attempt to access public, social services has a myriad of objectives. These objectives include: First, illegal immigrants would be deterred from accessing public services if they fear being reported to the INS and subsequently deported. Second, with more information on persons believed to be in the United States illegally, the INS would be able to deport more persons. Third, as part of broader anti-immigration programs, the mandatory reporting schemes aim to deter the flow of illegal immigrants into the United States and encourage those already here to return to their home countries. Currently, there are approximately 8 million illegal immigrants in the United States. n125 In 1995, the federal government deported 1,200 illegal immigrants. n126 Even if these objectives were successful to the point where it increased the number of deportations by an overwhelming ten-fold to 12,000 deportations per year, this would still leave the majority of illegal immigrants in the United States. n127 If there is a significant increase in the number of deportations, the number will be nullified by the illegal immigrants that are bound to enter into the United States in the meantime. n128 In essence, these objectives are meaningless towards decreasing the number of illegal immigrants through deportation. Even if the INS received a substantial increase in the names of illegal immigrants, history reveals that the INS is unlikely to apprehend and deport a number of illegal immigrants that would make any sort of significant impact. n129 Former New York City Mayor Rudolph Giuliani addressed the shortcomings of this legislation that is supposedly intended to help the problem with illegal immigrants. n130 In New York City, there are approximately 2,500 undocumented illegal immigrants in their prisons. n131 Furthermore, nearly 4,000 illegal immigrants go through the New York City jail [*587] system every year. n132 Although the names of these illegal immigrants are handed over to the INS for deportation, the INS successfully deported merely 300 of these convicted felons. n133 Therefore, the INS already has a significant source of illegal immigrants they could deport but have chosen not to. "The Federal Government does not deport enough illegal aliens in any given year to put a dent in the illegal population." n134 Should legislation be aimed at deporting desperate, innocent illegal immigrants seeking health care, when the INS already has more than enough names of felon illegal immigrants to deport with their current funding? n135 The answer is no. Instead of meeting the intended objective of deporting illegal immigrants, these sections only create a situation where poor, uninsured, illegal immigrants must fear going to public health care facilities and obtaining other essential social services. If this legislation is to be justified, deportation, not depriving these people from basic social services, must be the legitimate interest that the federal government is trying to accomplish. Creating indirect fear for illegal immigrants seeking much needed public health care services causes problems that are not justified by the federal government's modest number of deportations.

Changing status quo narratives by challenging notions of those who “deserve” health care changes public opinion and causes coalition building
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229ZE))


Increasingly, attention is being paid to the significant harmful effects on immigrants as well as the deleterious public health effects of these immigration-related benefit restrictions. This article examines the political, legal, and popular discourse in favor of and against healthcare benefit restrictions for immigrants in order to focus on a different aspect of this problem. Through this discourse, narratives are created of immigrants' character and relationship to the rest of society. These narratives influence our perception of immigrants and their effect on society, and this perception, in turn, seems to influence the policies enacted to regulate immigrants and immigration. These narratives have been constructed predominantly by those advocating for increased immigration control and benefit restrictions designed to make life in the United States for unauthorized immigrants less tolerable. Arguments favoring benefit restrictions reflect the narrative of an "Us-Them" dichotomy in which immigrants are labeled as criminals and welfare-abusers who jeopardize the health care of law-abiding citizens. Advocates for expanded health care access try to undermine this dominant narrative and offer a different one that portrays a more positive and complex relationship between immigrants, the health care system, and society generally. For example, those challenging benefit restrictions paint a very different picture of immigrants as self-sufficient, generally law-abiding, especially vulnerable to discrimination, and fearful of using public benefits. Immigrant rights groups and legal scholars also argue that many immigrant benefit restrictions are unduly harsh, racist,'8 and irrational because they undermine public health goals. 19 It is important to examine this discourse and determine the true impact of the immigrant health care narratives on policymaking. Narratives can influence popular opinion and grassroots coalitions that can either facilitate or hinder public advocacy for expanded access. They also help create or undermine the political will exerted on policy makers. But can pro-access advocates reconstruct the immigrant health narrative in a way that leads to greater health care access for immigrants? To the extent that pro-access groups hope to influence policy making through these reconstructed narratives, they should recognize two very important challenges they face. First, they should be mindful of whether the narrative they create supports their policy goals. If their discourse unintentionally reinforces parts of the dominant narrative used to fuel anti-immigrant initiatives, then they are undermining their own goals. Unfortunately, to some extent the pro-access narrative unintentionally encourages a view of immigrants as potentially dangerous and as outsiders. Moreover, to the extent that the pro-access narrative labels supporters of benefit restrictions as anti- immigrant or racist, this can facilitate public divisiveness among groups that might otherwise have common interests in reforming the health care system in ways that benefit both groups. Such characterizations may have the perverse effect of strengthening demand for anti-immigrant measures, which some political officials will support (or at least not aggressively oppose), even if irrational or harmful to citizens. Second, any attempt by pro-access advocates to use the immigrant narrative to influence policy will be constrained by the structural defects and linedrawing inherent in our existing healthcare framework. Apart from any consideration of immigration status, our health care system is largely based on an "Us-Them" paradigm in which access is not guaranteed for all, requests for coverage are automatically viewed with suspicion, and decisions about which groups in society should have access to health care are based on an amorphous analysis of who is most "deserving." Moreover, immigrants suffer discrimination along a number of axes, including race or ethnicity, socioeconomic status, and, in many cases, gender. Thus, discourse that successfully changes the immigrant narrative or increases public consciousness about their unique concerns will not necessarily garner public support for eliminating immigrant-specific barriers or ensure immigrants' access to care. Immigrants will still be left to compete with others for access to a health care system that perpetually pits one group against another. Considering our health system from the perspective of immigrants who are excluded because of immigration-specific barriers is still useful for a number of reasons. It shows how gaps in our current healthcare system have particularly harsh effects on those marginalized in society due to immigration status. It highlights the inherent, structural defects in our health system and shows how fighting for more rights for immigrants within an inherently inequitable system will only produce a limited benefit for some. Finally, it suggests that more creative approaches should be explored to enhance coalition building and effect fundamental health care reform that will improve health care access for everyone, including immigrants.

The plan acts as a litmus test—it challenges privileged notions of anti-immigration and causes political momentum for broader health care reform
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229
ZE))

Viewing the problems of our healthcare system through the immigrant lens also presents opportunities for crafting more creative solutions. In particular, it should encourage partnerships between citizens and noncitizens in building coalitions to advocate for comprehensive health reform. Immigrant communities have demonstrated a robust and powerful commitment to grassroots organizing and mobilization to protest actions considered anti-immigrant, despite the fact that these communities are typically politically, economically and socially vulnerable. Recall the massive protests and community mobilization seen all over the United States by immigrant communities in response to the Sensenbrenner bill in March 2006.224 In her recent book, Suburban Sweatshops, Professor Jennifer Gordon also describes examples of successful mobilization by unauthorized immigrants, particularly vulnerable to discrimination and labor violations, to fight for labor reforms.225 Citizens and noncitizens should also view each other as coalition partners in the fight for health reform because they suffer many of the same burdens and effects under the current healthcare system. Given the multiple axes along which immigrants suffer discrimination: age, gender, disability status, race-this leads to multiple opportunities for coalition building and lines of advocacy for reforming the healthcare system in ways that may or may not be immigrant-specific, but that will ultimately benefit immigrants as well.226 While immigrant-specific exclusions affecting children and people with disabilities have led to partnerships between these respective groups, gaps in the existing healthcare system that exclude immigrants and citizens should encourage partnerships and advocacy aimed at more fundamental reforms. Involving immigrant communities and advocacy groups in this broader health reform movement could generate the kind of momentum and political will needed to change the system.227 Professors Kevin Johnson and Jennifer Gordon gives examples of these kinds of partnerships in other contexts: women's and immigrants' groups fighting for relaxation in the requirements of immigration marriage fraud laws;228 these same groups partnering to achieve greater recognition of gender-based persecution for purposes of asylum;229 immigrants working with lesbian and gay organizations to repeal legal provisions interpreted to allow the exclusion of immigrants based on sexual orientation;230 and labor unions reaching out to include immigrants.23 At first glance, this kind of partnering may not appear as likely in the fight for greater access to public benefits.232 The examples provided by Professors Johnson and Gordon do not involve fighting for limited resources. They were fighting to reform the immigration process to ensure fair administration for groups marginalized in ways that violated our internal shifting norms about equality and fairness, to enhance labor protections, and to ensure that existing protections were being enforced for everyone. Any movement to increase economic entitlements or access to limited resources is going to be much more controversial and presents a greater challenge for immigrant communities. Despite these challenges, there is a meaningful chance that such partnerships can be used to successfully advocate for healthcare reform. First, the fact that patients do not get money directly, but rather receive coverage for health care, is important because health care providers and benefit administrators provide a gate keeping function.233 They help to ensure that resources are only used for a legitimate medical need, which minimizes, even if it does not completely eliminate, mistrust arising out of fears about fraud and waste in the distribution of resources.234 Second, because health care access has obvious public health implications, people's interests are interconnected in ways that should encourage collaboration rather than competition, and does not require singling out any particular group. Third, health care providers are potentially powerful coalition partners in heath reform efforts. Although examples of discrimination by healthcare providers were cited throughout this article, many providers believe they have a moral and ethical duty to treat all regardless of ability to pay or immigration status. They not only oppose immigrant-specific barriers, but have mobilized to fight for universal health care that would eliminate much, if not all of the problematic linedrawing currently used to distribute benefits. Moreover, they are also hurt economically by benefit exclusions that jeopardize federal and state funding for the services they feel a moral duty to provide.

Utilizing social services to integrate immigrants de-marginalizes them
(Barbara A. Arrighi, and David J. Maume, professors of Sociology and University of Cincinnati, 5/30/2007, Child Poverty in America Today: Health and Medical Care Volume II p.130)


Social service agencies have often had to mediate between immigrants and U.S. institutions as newcomers learn to adapt to their new environments. In the process, the environment has begun to become sensitized to the diversity of the new arrivals. Less focus has been placed on the systematic understanding of the socioeconomic levels of these immigrant groups and their implications for adaptation and achievement. Based on the allocation of immigration visas, there have been a variety of legal immigrant streams that have entered the United States in the last few decades. While earlier immigrants of the 1960s were, primarily of a professional stream, current streams are more likely to include large numbers entering throughout family reunification processes. These individuals and groups may not have the human capital and skills that are readily transferable into the fast·paced technological society. Consequently, the promised “land of milk and honey” may not be so for them. Two additional populations to the United States, refugees and undocumented immigrants, may find that they are frequently on the fringes of society—the former for a significant portion of their lives. and the latter, almost for their entire stay in the United States. Thus, a large segment of the immigrant group, particularly the newer immigrants of the last decade, is likely to be marginalized. Without the requisite English language competencies, education, and usable job skills, many hover at poverty levels.

There is no correlation between immigration levels and health care benefits. AND, immigrants are more likely to pay into the system than citizens
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229ZE))


Ironically, in the political discourse, as well as in popular commentary, restrictionists often use health care as an example of society's compassion and fair treatment of even unauthorized immigrants. They often cite the fact that emergency care is provided to anyone, regardless of immigration status and ability to pay, and other exceptions written into PRWORA also support this narrative.138 This narrative emerged during the 2008 presidential race, especially in the Republican primaries, where immigration was a critical issue. For example, Republican candidate Mike Huckabee seemed to be straddling a fine line between wanting to be viewed as "tough on illegal immigration," yet compassionate in supporting policies that do not punish or discourage immigrants in particularly vulnerable positions, such as victims of crime in need of police assistance or victims of an illness or injury requiring emergency care. 39 IV. DISCOURSE IN FAVOR OF EXPANDING ACCESS TO IMMIGRANTS Arguments made in favor of expanding access to immigrants challenge the wisdom of benefit restrictions and corresponding enforcement measures on deterrence, distributive justice, and retribution grounds. Pro-access advocates argue that policies limiting immigrants' access to healthcare benefits do not influence immigration-related decisions, undermine public health as well as health financing goals, and are not morally justified. In doing this, they challenge the dominant narrative of immigrants as morally blameworthy, undeserving criminals, and welfare abusers, who threaten citizens' access to health care. They also try to show why benefit restrictions are unduly punitive measures fueled by "anti-immigrant" and racist sentiments rather than necessary, rational measures to protect citizens. A. Challenging Deterrence Links A number of studies, as well as anecdotal evidence, undermine the asserted link between benefits availability and immigration decisions. Pro-access advocates always begin by noting that for years the data has shown that employment, not public benefit, is the primary motivator for illegal immigration or overstays.140 No correlation has been shown in the rate of immigration and narrowing of benefits eligibility; illegal immigration has continued to grow despite the state and federal trend toward greater restrictions and stepped up enforcement over the last decade.14' To counter the picture of the immigrant lured here by the prospect of getting public benefits, critics of health policy exclusions offer a competing narrative of immigrants as self-reliant and less likely than citizens to seek public benefits, even those to which they may be entitled. They criticize statistics about the number of immigrant families on public assistance as painting a misleading and very narrow picture of immigrants' use of public resources. For example, a demographer at the University of Southern California who has studied immigrants' use of public services found no evidence of large scale use of public benefits by unauthorized immigrants. 142 In fact, statistics show that immigrants tend to underutilize public benefits and generally have a net positive effect on the economy. 43 Considering the link between immigration and health care specifically reveals an even weaker case for deterrence justifications. A direct connection between health care access and decisions to immigrate usually is not and cannot be made for two reasons. The first is inherent in the healthcare market: health care tends to be given a much lower priority than employment, which is necessary for food and shelter, especially by people suffering from severe economic circumstances.144 The second reason is that the type of health care complained about often is unanticipated emergency health care.145 Even the "anchor baby" claim used by the Texas legislators to fight healthcare coverage for children of illegal immigrants is undermined by the Texas Hospital Association's own policy director who admits that "most illegal immigrants who go to major hospitals in Texas can show that they have been living here for years."'146 Pro-access arguments that public health benefits are not a motivating factor for immigrants are also supported by the data on immigrants' use of health services. Studies show that immigrants, especially unauthorized immigrants, underutilize healthcare benefits.147 Even legal immigrants and children of immigrants entitled to care tend to underutilize the healthcare system as a result of immigration-related benefit restrictions and enforcement policies.48 Moreover, some data suggests that immigrants are much more likely to pay for their health care than citizens in many cases, undermining the view of immigrants as welfare abusers.149 For example, although there are many reasons why immigrants may have trouble getting insurance and may need to rely on public benefits or assistance initially, data suggests that this reliance tends to be temporary and that "within a decade, new immigrants in California moved up quickly to steadier jobs with more benefits, and the rates of uninsured immigrants dropped sharply."

Even if states could fund health care benefits, federal restrictions scare immigrants away
(Brietta Clark, Prof of Law, Loyola Law School. 2008 (“The Immigrant Health Care Narrative and What it Tells Us About the U.S. Health Care System.” 17 Ann. Health L. 229
ZE))

One of the most controversial reporting requirements was proposed by President Bush. President Bush's policy would have required hospital personnel to check the immigration status of patients and report it to the federal government.50 While he ultimately abandoned this proposal, Congress found another way to encourage collection of this data.5' In 2003, Congress authorized some funding relief to hospitals providing uncompensated care to unauthorized immigrants.52 In order to qualify for federal reimbursement for emergency care provided to undocumented persons, however, hospitals are required to collect information proving that the patient is ineligible for public insurance, which necessarily involves gathering information related to immigration status.53 Finally, Congress heightened citizenship proof requirements for demonstrating Medicaid eligibility.54 These requirements were purportedly designed to prevent immigrants from making fraudulent claims to steal Medicaid benefits. In fact, these heightened requirements have created additional hurdles for citizens who are eligible for Medicaid.55

Vote AFF to change our risk analysis
Roger Tooze, Former Professor – London School of Economics, ‘2K
(Strange Power, Ed. Thomas Lawton, James Rosenau, and Amy Verdun, p. 191-2)


From this critical conception of ideology it is clear that the process of neoliberal globalization has gone hand-in-hand with the construction of enabling and supporting intersubjective meanings. The apparent triumph of neoliberal ideology in recent years is, however, the result of a long historical process in which the basic concepts of social life have been defined and constructed in certain ways (see Polanyi 1957). In this historical process even the unquestioned meanings of deeply embedded core social practices, such as what constitutes economic activity, become changed to fit particular interests, but are kept in the realm of what Bourdieu calls ‘dox’ where ‘the natural and social worlds appear as self-evidence’ (Bourdieu 1977: 164; also see MacLean 2000). Hence the purpose of neoliberal ideology is the construction of a sense of reality that the present social structure of global capitalism and the distribution of wealth and power engendered by that social structure is, and should be, natural. That is that the global capitalist society is not the product of power and arbitrariness, but of normal and natural processes that have to be accepted. In this context, the summary argument that Bauman makes regarding neoliberal ideology needs emphasizing here: The point of similarity between the neo-liberal world-view and a typical ‘classic’ ideology is that both serve as a priori frames for all future discourse, setting what is seen apart from what goes unnoticed, awarding or denying relevance, determining the logic of reasoning and the evaluation of results. What, however, makes the neo-liberal world view sharply different from other ideologies – indeed, a phenomenon of a separate class – is precisely the absence of questioning; its surrender to what is seen as the implacable and irreversible logic of social reality. (Bauman 1999: 127) In the ‘natural’ processes of globalization the political goal is to achieve a ‘self-evident’ structure of (global) society in which there is as near as possible a ‘quasi-perfect correspondence between the objective order and the subjective principles of organization’. In order to achieve this, those who wield power must capture the ‘instruments of knowledge of the social world’, as these are political instruments which contribute to the reproduction of the social world by producing immediate adherence to the world, seen as self-evident and undisputed, of which they are the product and of which they reproduce the structures in a transformed form. (Bourdieu 1977: 164) Hence the importance of not allowing epistemology (one of the key instruments of knowledge of the social world’) to be defined as ‘given’, as outside the parameters of what we in academic IPE should question. As Strange argued in the last lines of her last piece of writing, ‘although academic debate by itself rarely changes the basic ideas…that at any time dominate the knowledge structure, academic debate when it takes place against a background of growing disillusion, or doubt and uncertainty, can act as a catalyst to action.11 One can only hope that, as in so many other aspects of IPE, she is right.