Fact check: Rep. Ronny Jackson falsely claims undocumented immigrants have ‘easier access’ than most citizens to health care and voting

By Daniel Dale, CNN

Republican Texas Rep. Ronny Jackson, a doctor who formerly served as White House physician to presidents Barack Obama and Donald Trump, made a sensational claim this past weekend about undocumented immigrants.

“In 2022, illegal immigrants will have MORE FREEDOMS and easier access to healthcare and ballot boxes than most Americans… Just think about that,” Jackson, who has more than 190,000 Twitter followers, tweeted on Sunday.

CNN researched his claims in detail. They are not even close to true.

Facts First: Jackson was thoroughly incorrect. Undocumented immigrants are prohibited from voting in all federal elections, all state elections and almost all local elections; the vast majority of citizens have the right to vote in all three. And undocumented immigrants, unlike citizens, are prohibited from receiving health insurance coverage from Medicare, Medicaid (with the exception of emergency Medicaid), the Children’s Health Insurance Program (though some states use CHIP to cover prenatal care for all) and Affordable Care Act exchanges.

“Rep. Jackson’s statement is wildly inaccurate,” San Francisco State University political science professor Ron Hayduk, who studies political participation and immigration and wrote a book on noncitizen voting, said in an email. Hayduk added: “I’m not sure what world Rep. Jackson lives in but it surely is not in the real world of the U.S. and its 50 states, even accounting for variations among states. The facts are clear and indisputable.”

Jackson’s office didn’t respond to a request for comment. As of Thursday, his tweet had generated more than 3,100 retweets.

CNN won’t try to fact check Jackson’s extremely vague claim that undocumented immigrants will have “MORE FREEDOMS” than most Americans in 2022. But let’s go through his claims that undocumented immigrants will have easier access than citizens to ballot boxes and to health care.

Undocumented immigrants and ballot boxes

Jackson’s claim about undocumented immigrants having easier access to “ballot boxes” this year than most American citizens is completely false.

Like other noncitizens — from visitors on short-term visas to permanent residents with green cards — undocumented immigrants can’t vote in federal elections such as the congressional midterms of 2022. And like other noncitizens, undocumented immigrants can’t vote in state elections such as the 36 elections for state governor in 2022.

There are a small number of communities — 15 cities and towns in total, according to Hayduk — in which at least some noncitizens can legally vote in at least some local elections. In San Francisco, noncitizens including undocumented immigrants can vote in school board elections and school board recall elections if they have a child under age 19 who lives in the city. New York City just passed a law that gives certain noncitizens the right to vote in municipal elections including the mayoral election; New York City’s list of eligible noncitizens includes “Dreamers” — undocumented people who arrived in the US as children — who have obtained work authorization through the federal DACA (Deferred Action for Childhood Arrivals) program, but not the entire undocumented population.

Jackson’s claim would have been wrong even if it was specifically about New York City and San Francisco. Undocumented residents there do not have “easier” access to ballot boxes than most citizens. Rather, in a limited set of elections, some undocumented residents there have the same access as most citizens.

Undocumented immigrants and health care

Undocumented immigrants have some access to health care. In general, however, they have significantly less access than American citizens do — though, of course, many citizens face their own challenges dealing with a US system that is consistently ranked as less accessible than the systems of other wealthy countries.

Unlike citizens, undocumented immigrants are “basically excluded from participation in all federal health programs,” said Samantha Artiga, director of the racial equity and health policy program at the Kaiser Family Foundation, which studies US health care.

As noted above, that means undocumented immigrants are denied access to Medicare, to Medicaid except for very limited emergency coverage, to the Children’s Health Insurance Program with the exception of pregnancy care in some states, and to Affordable Care Act exchanges. Undocumented immigrants are not only prohibited from purchasing subsidized insurance through these exchanges but even from using the exchanges to buy insurance at full price.

The Kaiser Family Foundation reported that in 2019, 46% of undocumented immigrants were uninsured, compared to 9% of citizens. “And people who are uninsured go with less health care,” Artiga said. “They face more barriers to accessing health care because of financial barriers.” Even when undocumented people do have access to health services, she added, some are reluctant to access them because they fear immigration consequences.

There are various ways that undocumented immigrants do receive health care. Some get private insurance through employers. Uninsured people can get some low-cost care at community health centers. Some undocumented immigrants rely on hospital emergency departments, which are legally required to treat anyone who shows up, though these patients can get stuck with substantial bills.

In addition, there are publicly funded coverage options for some undocumented people in some parts of the country. For example, six states and Washington, DC, use their own funds to provide health insurance to children from households below certain income levels regardless of immigration status. California is poised to expand coverage to its entire low-income population including undocumented people.

But even in a state like California, undocumented immigrants would not have “easier access” to health care than most citizens do. At most, undocumented residents would be granted equivalent access.

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