Liberals seek health-care access for illegals
By Stephen Dinan
The Washington Times, September 28, 2009
Fearful that they're losing ground on immigration and health care, a group of House Democrats is pushing back and arguing that any health care bill should extend to all legal immigrants and allow illegal immigrants some access.
The Democrats, trying to stiffen their party's spines on the contentious issue, say it's unfair to bar illegal immigrants from paying their own way in a government-sponsored exchange. Legal immigrants, they say, regardless of how long they've been in the United States, should be able to get government-subsidized health care if they meet the other eligibility requirements.
'Legal permanent residents should be able to purchase their plans, and they should also be eligible for subsidies if they need it. Undocumented, if they can afford it, should be able to buy their own private plans. It keeps them out of the emergency room,' said Rep. Michael M. Honda, California Democrat and chairman of the Congressional Asian Pacific American Caucus.
Mr. Honda was joined by more than 20 of his colleagues in two letters laying out the demands.
Coverage for immigrants is one of the thorniest issues in the health care debate, and one many Democratic leaders would like to avoid. But immigrant rights groups and the Democrats who sent the letters say they have to take a stand now.
President Obama has said he does not want health care proposals to cover illegal immigrants. The bill drawn up by Sen. Max Baucus, Montana Democrat and chairman of the Senate Finance Committee, excludes illegal immigrants from his proposed health care exchange.
Mr. Honda and his allies, though, say illegal immigrants should be allowed to pay for insurance if they can afford it, even if it comes through a government-established exchange. As a generally young, healthy part of the population, illegal immigrants could help reduce overall costs for those who buy into health exchange plans, the lawmakers said.
The Democrats' letters, however, do not issue ultimatums or threaten to withhold support for the bills if their requests aren't met.
The National Council of La Raza launched its own 'flood their voice mail' campaign last week to put pressure on Mr. Baucus to expand coverage in his proposal to include all legal immigrants and to drop verification language in the legislation that would prevent illegal immigrants from obtaining coverage.
Mr. Honda told The Washington Times that he's not pushing for illegal immigrants to gain access to taxpayer-subsidized benefits. 'That's an argument that's been done already,' he said.
Rep. Steve King, Iowa Republican, said proposals that include government coverage for illegal immigrants leave him incredulous.
'If anybody can, with a straight face, advocate that we should provide health insurance for people who broke into our country, broke our law and for the most part are criminals, I don't know where they ever would draw the line,' he said.
Mr. King, who opposes Democrats' health care plans in general, said illegal immigrant access in legislation 'would be a poison pill that would cause health care to go down' to defeat.
Twenty-nine Democrats signed on to the letter on legal immigrants, while 21 signed the letter on covering illegal immigrants. Although the leadership of the Congressional Black Caucus signed the legal-immigrant letter in their capacity as CBC officials, they signed the other letter as individual members of Congress.
Under the 1996 welfare law overhaul, Congress restricted most federal benefits to longtime holders of green cards – those who have been in the country at least five years.
But Democrats chipped away at that rule when they reauthorized the State Children's Health Insurance Program earlier this year and allowed states to cover all immigrant children and pregnant women, regardless of how long they've been in the country.
In their letter, the Democrats said health care costs are much lower for legal immigrants than for native citizens.
'Immigrants are part of our families, our communities, our economy, and contribute to the fabric of America,' they wrote. 'It is simply wrong that their taxes would pay for public health insurance programs to which they are not allowed access.'
EDITORS NOTE: CIS Director of Research Steven Camarota has recently offered his perspective on health care reform, available online at: http://www.pittsburghlive.com/x/pittsburghtrib/opinion/s_645010.html
CIS estimates of the potential cost of covering illegal aliens are available online at: http://www.cis.org/IllegalsAndHealthCareHR3200
The collection of CIS materials on the cost of illegal aliens is available online at: http://cis.org/Announcements/HealthCare-Immigration-Publications
Everyone will suffer if illegal immigrants aren't covered in reform, some caregivers say
Florida, home to a million undocumented immigrants, pays big to take care of those who can't get insurance, including those here illegally. If health care reform leaves out the undocumented, we'll still be paying, caregivers warn.
By William E. Gibson
The South Florida Sun Sentinel (Fort Lauderdale), September 25, 2009
Washington, DC — Excluding undocumented immigrants from health care reform could jeopardize everyone's health and perpetuate a costly gap in insurance coverage, medical experts warned this week.
Much of the point of health care legislation in Congress is to cover all Americans to protect the public health and ease the high cost of treating uninsured patients in emergency rooms. Some health leaders worry that leaving the undocumented out of a newly created health care system would impair attempts to prevent the spread of infectious diseases, such as tuberculosis or swine flu, and continue the growing burden on public hospitals.
The gap in coverage is especially big in Florida, home to a million undocumented residents.
The warnings come while the Senate Finance Committee is drafting a bill designed to prevent illegal immigrants from tapping into new health care marketplaces, known as exchanges, where individuals and small businesses could shop for insurance.
The committee, which will resume its work next week, is expected to produce a bill that would require consumers to show proof of citizenship or legal status when joining these exchanges. The bill also would prevent the undocumented from getting tax breaks designed to make insurance affordable. And it would force newly arrived legal immigrants to wait five years before joining exchanges or getting tax breaks.
Some health leaders in Florida fear these exclusions and restrictions would undermine the advantages of reform.
'If I'm standing next to someone who has tuberculosis and who is uninsured, it doesn't protect me if they aren't treated,' said Fernando Trevino, dean of the School of Public Health at Florida International University. 'To the degree that someone is not getting care, they are more likely to spread infectious diseases to the rest of the population.'
He and other public-health experts also say any bill that leaves a big gap in coverage would miss an opportunity to lower costs by providing preventive care to everyone.
'People forget that we already provide inefficient and expensive care to undocumented residents,' said Dr. Olveen Carrasquillo, chief of general internal medicine at the University of Miami medical school. 'They come into emergency rooms with advanced stages of an illness. Often they have medical conditions that are very expensive to treat but could have been prevented with primary care.'
Restrictions on the undocumented, if approved by Congress, would apply to new benefits provided by the reform legislation. The exclusion would not block immigrants from buying insurance on the private market outside these exchanges.
These measures stem from a determination to prevent explosive immigration issues from derailing an overhaul of the health care system. President Barack Obama tried to assure Congress in a nationally televised speech this month that 'the reforms I'm proposing would not apply to those who are here illegally.'
The remark sparked an outcry from conservatives – most immediately from Rep. Joe Wilson, R-S.C., who shouted, 'You lie!' during the address to Congress. Wilson and many other Republicans say the reforms being considered would allow illegal residents to sneak into the health care system at taxpayer expense.
The undocumented have access to health care. By law, hospitals and other providers are required to treat all patients who need emergency care.
Public clinics in South Florida and elsewhere do not ask patients about their immigration status. They also give vaccinations for such things as swine flu without demanding documents.
But some public-health leaders are concerned that the heated rhetoric and exclusions coming out of Washington will further discourage immigrants and some U.S. citizens. They say some residents who don't speak English or meet the profile of a typical American – even those here legally – are reluctant to show up at public facilities for fear of harassment or deportation.
'By not covering them, we are choosing the worst for them and the worst for the rest of us in terms of financial cost,' Carrasquillo said. 'We end up paying for it.'