To the Editor The recent Original Investigation by Cervantes and colleagues,1 the Research Letter by Gray and colleagues,2 and the Invited Commentary3 by Fernández and Rodriguez accompanying both articles, demonstrate the problems undocumented persons face in obtaining health care in the United States. Policies affecting this group are mostly based on political principles rather than on facts and ethics. These studies1-3 demonstrate that managing undocumented immigrants outside the health care system, without provision of any form of primary, coordinated or preventive care, and only allowing access to emergency care, is inefficient, inequitable, and has poor outcomes. It is also more burdensome and more expensive to the larger health care system.4