Extending health coverage to illegal immigrants is sound policy. The inclusion of the illegal-immigrant population may lower costs in numerous ways, including lower insurance premiums, lower emergency medical expenditures, and a switch from expensive late-stage treatments to cost-effective preventative and ambulatory care. Coverage will obviously benefit illegal immigrants, but the entire US population will also reap the rewards of a broader risk pool comprising individuals with comparatively low medical expenditures and usage trends. Extending coverage could also have important public health benefits. Ensuring treatment, especially of infectious disease, protects the health of the population as a whole, and this is particularly important considering the ease of travel and access to different parts of the globe. The public health is also served by prompt diagnosis and treatment of chronic diseases, such as heart disease and diabetes. Allowing illegal immigrants to stay and pretending they're not here doesn't work for anyone. Prohibiting inclusion of illegal immigrants in the formal healthcare system and at the same time extending piecemeal benefits, emergency rooms, and some patchwork of state and local governments is a poor way to address the intractable problem of ever increasing health care costs. The federal government should meet this challenge head-on in the form of health coverage, recognizing the benefits that could accrue to it by instituting necessary health insurance reforms. Even if immigration reform does materialize, nothing will have been lost by providing coverage in the interim. As the illegal immigrant population declines, for instance, because of fewer economic opportunities in the United States or absorption into the lawful immigrant category, the system has enough fluidity to respond. Further tweaks may be necessary, but incremental improvement is a characteristic of any public benefits scheme. What is not acceptable is to tacitly ignore the problem while setting up additional barriers to coverage.