No, Democrats Are Not Shutting Down the Government to Give Illegals Healthcare

The completely fact-free debate over the continuing resolution

One of the first political books I ever read was What’s the Matter with Kansas? by Thomas Frank. This was nearly two decades ago, so I don’t remember many details, but the basic idea was that Republicans were conquering rural America and winning over downscale whites by running on cultural issues, even as they favored small government policies that went against the best interests of the poor.

I don’t agree with the idea that pro-market policies are bad for most people. But everything else about this theory is correct, and completely within the mainstream of political science. If people voted on economic issues, they would overwhelmingly elect Democrats over Republicans. But many Americans are ignorant about policy specifics and have conservative views on topics like affirmative action, LGBT rights, abortion, and illegal immigration, which puts them solidly in the Republican camp. Even when polls sometimes say Americans prefer Republicans on the “economy” in the abstract, when you survey them on actual issues most voters are closer to Democrats. There is nothing special about the American public in this regard – people like economic statism everywhere, which is why most developed countries have even more regulations and a larger welfare state than we do.

If you wanted a confirmation of this thesis, you couldn’t script a story better than the events surrounding the current government shutdown. The dispute centers on whether a short-term spending bill, called a continuing resolution, should include major healthcare provisions. Republicans, who control Congress and the White House, passed a clean bill to extend funding until late November at current levels, insisting that Democrats are holding the process hostage by demanding unrelated policy concessions. Democrats, meanwhile, have refused to provide the votes needed for cloture in the Senate unless the package restores recent Medicaid cuts and extends Affordable Care Act subsidies enacted during Covid.

So this is a debate over healthcare spending. And as you might guess, voters overwhelmingly support the more left-wing position. A June poll showed 77% wanting to extend the ACA tax credits, including 63% of Republicans. That number rose to 84% when respondents were told that letting them lapse would cause millions to lose their health coverage

How do Republicans deal with being in such an unpopular position? By simply lying about the entire debate. As Trump posted on Truth Social, “The Democrats want Illegal Aliens, many of them VIOLENT CRIMINALS, to receive FREE Healthcare.” The AI video he posted of House Minority Leader Hakeem Jeffries in a sombrero hammered home that point, and had the added benefit of raising the salience of the culture war aspects of the debate. Vance repeats the boss’s line: “Democrats are about to shutdown the government because they demand we fund health care for illegal aliens.” Trump was at one point also arguing that Democrats were fighting for government-paid sex change operations, though that message has fallen by the wayside as Republicans have focused exclusively on immigration.

Where does this idea of the shutdown being about healthcare for illegals come from? According to federal law, Medicaid and ACA subsidies exclude undocumented residents. It is true that if an illegal immigrant who would otherwise be eligible for Medicaid shows up to the emergency room, they must be taken care of. As you might expect, since this demographic is young and a small part of the population, this makes up less than 1% of total Medicaid spending. I don’t think letting people who arrive at the hospital die is anything either side is willing to push for. All of this hasn’t stopped JD Vance from in effect telling people that if they ever have to wait in an emergency room, it is the fault of illegal immigrants.

It’s true that some liberal states provide healthcare to all residents, regardless of legal status. This has led Republicans to therefore argue that the federal government in effect subsidizes such programs by freeing up money places like California and Illinois would instead spend on citizens. The Democrat proposal does in fact roll back changes in Medicaid funding that would incentivize states not to cover those in the country illegally, though this would apply to a minority of states and may not even change their policies.

But we’re talking only about a tiny portion of the funding being fought over. That is, almost nothing about the current debate is specifically about illegal immigrants! One could argue Republicans themselves are funding healthcare for illegal immigrants by providing any ACA subsidies and Medicaid coverage at all. Are we to believe that the only people who want to fund healthcare for undocumented migrants are those who want to spend one dollar more than Trump and Republicans do? Some illegals may lose health insurance in a roundabout way if Republicans prevail in this dispute, but the vast majority of those seeing their coverage lapse will be American citizens.

Peter Thiel famously once said he doubted whether democracy and freedom were compatible because people wanted big government. But Republicans have figured out how to hack democracy. Just lie! The people won’t know the difference, as long as your opponents remain somewhat socially liberal and woke. Is the debate over spending on infrastructure? Illegal immigrants drive on roads! Education? Undocumented children go to school! You never actually have to defend unpopular positions.

This is why I find it so funny when people tell me that we have to stop immigration or we’ll get a larger welfare state. Republicans are completely unwilling to argue for cutting spending on anything. And for good reason, because the American public hates the idea. All that conservatives have – the only thing they can point to in order to defend a small government position – is fear among the public that illegals, and sometimes black people, might get benefits that they don’t deserve.

I’m not a supporter of more government healthcare spending. I think it distorts markets and drives up costs, and is likely not justified using standard tools of cost-benefit analysis. On substance, I am on the side of Republicans here. Yet it’s still quite crazy to have a political debate in which one party just completely lies about what is going on. In the long run, having a movement led by people who care nothing for the truth is not the best way to get wise and moral leadership.

What are Democrats to do? They may need to pivot hard on the issue of welfare for illegal immigrants. You can advocate $1 billion in spending on healthcare, and $999,999,999 of it can go to citizens, but if there’s a theoretical possibility that the last dollar benefits illegals, Americans will go from supporting the liberal position by 70-30 to being approximately evenly divided. The public is that paranoid about helping non-citizens. Democrats are going to have to take a hard line position here, and advocate some policies that are as of now completely outside the Overton Window for them, like conditioning Medicaid subsidies on states not providing healthcare to illegals. Defending the status quo and calling for more spending will not be enough.

Even in that case though, Republicans could probably still lie, and Democrats will have sacrificed their principles for nothing. A better path might be to take a harsher tone towards illegals, maybe strategically employing racial slurs. Have party leaders rant and rave about how much they hate Mexicans and introduce the “Death to Beaners Act,” which despite its harsh name actually throws the borders open and showers new arrivals with benefits, or does whatever else they think would be good policy.

I’m only half joking. This kind of strategy would be impossible to pull off, as people have a hard time pretending they’re something they're not, and the public can sense a lack of authenticity. Chuck Schumer can’t fool people into thinking he is Donald Trump. But I think that the indifference of the Republican Party towards truth at this point in history indicates that Democrats will continue to struggle until they figure out how to change the perception that they care too much about foreigners.