It took just a few seconds for the Democratic presidential candidates to raise their hands, but some are still talking about it almost three weeks later.
“Raise your hand if your government plan would provide [health care] coverage for undocumented immigrants,” said moderator Savannah Guthrie on the second night of the Democratic debate last month. All 10 candidates – including former Vice President Joe Biden and Sen. Bernie Sanders – signaled that their answer was yes.
President Donald Trump didn’t even wait until the end of the debate to declare in a tweet, “That’s the end of that race!”
It was, of course, far from the end of the race, but it’s a position that some candidates have been compelled to clarify and follow up on, particularly as critics argue against providing health care to undocumented immigrants as 13.7% of U.S. adults lack insurance coverage.
South Bend, Ind., Mayor Pete Buttigieg was the first to jump in. From the debate stage he emphasized, “this is not about a handout,” adding “we do ourselves no favors by having 11 million undocumented people in our country be unable to access health care.”
Others have sought to define exactly what they mean by the word “coverage.”
Biden – who raised and then lowered his hand so quickly that the moderators initially thought he hadn’t raised it at all – was asked about the issue on Monday at an AARP candidate forum in Iowa.
He first noted that many undocumented workers pay into to safety net programs (about $13.3 billion into Social Security every year) and should be able to buy into health coverage. According to the Kaiser Family Foundation, among the nonelderly population, 45% of undocumented immigrants are uninsured, compared to less than 8% of citizens.)
The key distinction was between being covered and getting health insurance. “It’s inhumane if we have undocumented folks” without access to any care, he said. He added: “That doesn’t mean they have health insurance, that means they get covered for the crisis they are facing at the moment.”
‘Coverage’ is the wrong word
Biden’s plan would allow undocumented workers to buy into a public option only if they are paying into Social Security. The rest would rely on public health clinics. (Biden released details of his broader health care plan on Monday, which would create a public option that would let anyone to sign up for a government-run health plan like Medicare, and allow more people to get subsidies.)
“‘Coverage’ is the wrong word” is how Sen. Kirsten Gillibrand started her answer when Yahoo Finance brought up the issue during an interview for Yahoo Finance’s Meet the Candidate series.
“When you only allow people to get health care through an emergency room when they're in crisis, it's the most expensive health care in the world,” she said. “If you want to bend that cost curve and lower prices of health care costs, get everyone into preventive care.” Gillibrand said she would focus on getting all immigrants care with an expansion of Medicare alongside a pathway to citizenship.
Other candidates’ plans are more straightforward. Before the Democratic candidate debate, the Sanders campaign wrote: “Medicare for All means just that: all. Bernie’s plan would provide coverage to all U.S. residents, regardless of immigration status.”
Sen. Kamala Harris’s state of California recently passed a law to provide health care coverage to some undocumented adults.
Undocumented workers are currently barred from participating in the Obamacare exchanges. The infamous moment when Rep. Joe Wilson yelled “You lie” during a 2009 address to a joint session of Congress was at the moment when President Obama was making the (truthful) point that illegal immigrants would not be covered.
The question is likely to keep coming up and candidates at least want time to explain. Biden is clear: “I’m not doing any more raise-your-hand issues,” he said in Iowa.
CNN, the host of the next debate, has already said that there will be no show of hand or one-word, down-the-line questions in Detroit at the end of the month.
Ben Werschkul is a producer for Yahoo Finance based in Washington, D.C.