November 11, 2009, 4:17 pm
Illegal Immigration May Be a Rift Issue
By KEVIN SACK

Abortion will not be the only social issue dividing Congress as it seeks to construct a compromise health care bill capable of passing both houses. The legislation the House passed on Saturday by a narrow margin also sets up a looming confrontation with the Senate over the extent to which illegal immigrants should have access to public resources.

In this case, the public resource is a government-run health insurance exchange, or marketplace, that would be designed to slow the growth of premiums by allowing consumers to comparison shop for standardized policies.

Neither the House bill nor the bill that has passed the Senate Finance Committee would allow illegal immigrants to benefit directly from government-subsidized health coverage. As now, they would not be eligible for Medicaid or Medicare, the government insurance programs for the poor, elderly and disabled. Nor would they qualify for new tax credits intended to make premiums affordable for those making up to four times the federal poverty level, or $88,200 for a family of four.

But under pressure from members of the Congressional Hispanic Caucus, whose votes were needed for passage, House leaders decided to allow illegal immigrants to shop for insurance on the exchange. The immigrants would have to pay the full cost of their policies. But the exchange, which would be created and operated with taxpayer dollars, might provide them with lower prices than available on the open market. And one option would be a new government insurance plan.

In the Senate, there is a dispute between bills passed by the Finance Committee, which would bar illegal immigrants from exchanges, and the Health, Education, Labor and Pensions Committee, which would not. But the ban is expected to be included in the compromise legislation now being drafted by Senate leaders, with President Obama’s support. Under either bill, emergency rooms would still have to treat illegal immigrants who are in medical crisis.

Those who oppose allowing illegal immigrants in the exchange acknowledge that their position is largely symbolic. They doubt that significant numbers of uninsured immigrants would be able to afford the exchange’s premiums without subsidies.

Although the numbers are speculative, researchers estimate that about 7 million of the country’s 46 million uninsured are illegal immigrants. And researchers estimate that more than 90 percent of them fall under the affordability threshold of four times the poverty level. (Some illegal immigrants – perhaps 40 percent — are insured, often through employers or a spouse.)

But even allowing undocumented workers into the exchanges “would seem to leave the sense that the government is not very serious about its immigration laws,â€