Hispanic Groups Push Illegal Immigrant Health Coverage

Chattanooga Times Free Press (Tennessee)
November 15, 2009 Sunday
WASHINGTON, D.C.

WASHINGTON -- Hispanic advocacy groups are ramping up pressure on Congress to expand health coverage for illegal immigrants as the lawmakers grapple with historic health reform legislation.

Activists and health policy experts who support greater immigrant coverage are concentrating their efforts on the Senate, which is expected to bar undocumented immigrants from participating in health insurance exchanges, as stipulated in the Senate Finance Committee's bill, even if they pay full price with their own funds.

The House voted last weekend to deny federal subsidies to help undocumented immigrants buy insurance but allow them to buy health insurance from government-created insurance exchanges.

The Senate Democratic leadership is working to merge two bills before bringing the legislation to the floor for debate.

However, the major Senate bill -- the one written by the Senate Finance Committee -- goes further than the House bill and bars undocumented immigrants from obtaining health insurance with their own money at insurance exchanges.

"We do not see the same investment (in immigrants) in the Senate, and I think that will be a major component in the outreach by many other Latino organization," said Jennifer Ng'andu, deputy director of health policy at National Council de La Raza, which lobbies both houses of Congress to make insurance accessible to immigrants.

Steven Wallace, associate director of the UCLA Center for Health Policy Research, said he doubts that the final Senate bill would go beyond the House measure.

"My hope is the Senate is a little more enlightened, but my guess is they'll come up with more punitive measures than the House," Wallace said.

Rep. Michael Honda, D-Calif., who pressed the House leadership to ensure that undocumented immigrants could still purchase insurance at full price, argued that including immigrants would help reduce overall health care costs for everyone.

There are an estimated 12 million undocumented immigrants in the U.S., according to the Migration Policy Institute, a pro-immigration think tank. They comprise 15 percent of the country's total uninsured population, the institute says.

Elena Rios, president of the National Hispanic Medical Association, said Hispanics have the highest proportion of uninsured people.

"Diseases know no boundaries," she said. "The best idea would be to have everyone have health care."

But health policy experts say that regardless of cost analyses, covering undocumented immigrants will remain a political problem for lawmakers who want to look tough on immigration.

"It's very tough to get legislation that's humanitarian toward undocumented folks even if it does make sense for public health," said Anne Dunkelberg, associate director of the Center for Public Policy Priorities in Austin, Texas.

Lawmakers' hypersensitivity to immigration makes health care reform "more complicated and less effective," Wallace said.

The recessionary economy makes the immigration issue even more touchy.

"In a contracting economy, these issues become rather explosive," said Dan Stein, president of the Federation for American Immigration Reform, which supports immigration limitations. " He accused Democratic congressional leaders of trying "to use health care to reengineer immigration policy."

Health insurance coverage for immigrants has been a debate for a long time, but it attracted national attention in September when Rep. Joe Wilson, R-S.C., shouted "You lie!" after President Obama -- speaking to a joint session of Congress -- promised that health care reforms "would not apply to those who are here illegally."

Wilson, along with Rep. Dean Heller, R-Nev. and Rep. Nathan Deal, R-Ga., later worked unsuccessfully to have the House-passed bill bar undocumented immigrants from participating in insurance exchanges, even if they paid their own way.

The Wilson outburst "illustrated how this issue has moved to the forefront," Stein said. "Public mood for lavish public spending for people who have no right to be in the country has ended."

Another point of contention is how verification systems will be used to weed out undocumented immigrants. House and Senate bills would implement an electronic system that would check the legal residency of an applicant for federal insurance subsidies, identical to Medicaid's system. But the Senate would extend the verification system to non-citizens who want to participate in the insurance exchange on their own, without subsidies.

Hispanic advocates and health policy experts say that expanded verification systems are a waste of millions of dollars of tax money for a barrier that catches a miniscule number of undocumented immigrants and screens out many more U.S. citizens and legal residents who don't have the necessary citizenship documentation.

Up to 13 million illegal immigrants lack a driver's license, birth certificate or passport, Ng'andu said.

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