Medical Cost of Illegal Aliens Is Hot Potato - Medicare and Medicaid being drained

Medical Cost of Illegal Aliens Is Hot Potato
Wednesday, 01 Aug 2012 08:16 PM
By James Walsh

No one wants to diagnose the major healthcare problem facing the United States today, and no one wants to acknowledge the role of illegal aliens in driving Medicare and Medicaid over the cliff.

Medicare, a federal health insurance policy amended to the Social Security program (Title XVIII) in 1965, is not nor has it ever been free.

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President Obama announced that no deportations would be processed of well-behaved illegal aliens under 30. (Getty Photo)

U.S. workers have Medicare payments deducted from their paycheck and after retirement from their Social Security check. Medicare covers about 80 percent of bills for hospitals, doctors, medicine, rehabilitation, and ambulance services for persons over 65 years of age, persons younger than 65 with certain disabilities, and all persons with end-stage kidney failure.

To cover the balance, Medicare customers purchase supplemental insurance on the open market. Medicare is impacted when Congress regularly raids the Social Security account for other purposes.

In contrast, Medicaid is a federal assistance program for low-income and disabled persons paid for by taxpayers at large. Medicaid also was amended to the Social Security program (Title XIX).

Medicare is today a troubled program bloated by unemployment and illegal immigration.

Medicare and Medicaid were passed by Congress in 1965 as part of the Great Society and War on Poverty of President Lyndon Baines Johnson (LBJ). The Democrat Party then controlled the White House and both Houses of Congress.

Democrats anticipated that Medicaid would be governed by a set of complex rules and bureaucratic regulations with the states determining eligibility. Medicaid costs for the 1960s were estimated at $2.5 billion to $4.7 billion per year. By 2008, Medicaid costs had mushroomed to an unsustainable $299 billion, and that was four years ago.

Even though Medicare recipients are paying customers, the Social Security Administration (SSA) lumps Medicare and Medicaid together under public assistance expenditures. In contrast, Medicaid is public assistance.

As one Democrat Congresswoman noted, “It’s free money.” It is not. Taxpayers pay Medicaid bills of indigent citizens and noncitizens, among them illegal aliens.

The theoretical concept of the Great Society/War on Poverty programs was to equalize the “haves and the have-nots.”

Redistribution of wealth was advanced by revising immigration laws. The Immigration and Nationality Act of 1965 (INA), sponsored by Senator Phil Hart, D-MI, and Congressman Emanuel Celler, D-NY, opened the doors to third-world immigrants.

Developed countries, mostly in Europe, had been the primary recipients of U.S. immigrant visas. Dissent was drowned out by LBJ and Senator Ted Kennedy (D-MA), who assured Americans there would be “no demographic changes in the population.”

LBJ, Senator Kennedy, and Congressional Democrats had to know that the INA would change U.S. demographics, just as Medicaid would increase the dependency of U.S. citizens and non-citizens on the federal government. They had to know that Medicaid plus open-door immigration would reshape the nation as an entitlement state drawing legal and illegal immigrants.

Half a century later, a Jan. 22, 2008, USA Today article did dare address the rising costs of healthcare for illegal aliens, stating: “. . . illegal immigrants rely on a patchwork of federally funded community health centers, which charge little for basic services and don’t seek proof of citizenship.” The number of illegal aliens on Medicaid continues to rise.
On June 15, President Barack Obama announced that no deportations would be processed of well-behaved illegal aliens under 30 years of age, who instead would be issued two-year work permits. This is another example of executive-bureaucratic fiat in violation of U.S. immigration laws.

Over the years, Medicaid eligibility has been widened far beyond the law. States have permitted legal and illegal aliens, such as student visa holders, to benefit from lax Medicaid eligibility.

Untold numbers of illegal aliens, posing as legal residents and using forged and fraudulent documents, receive Medicaid benefits for children and “disabled” adults and Medicare for elderly non-citizens.

On July 27, the National Immigration and Customs Enforcement Council president explained how President Obama’s June 15 executive/bureaucratic fiat providing work permits for illegal alien youths is being applied.

U.S. Department of Homeland Security (DHS) officials have instructed U.S. Border Patrol agents to release any alien who claims to have gone to high school. No agent may question a person’s claim of being a “DREAMER” (an illegal alien youth), nor may an agent question a claimant’s age or language skills.

Across the nation, it is now unacceptable to question any applicant for benefits about their citizenship, for to do so would demonstrate insensitivity and racist bias. The mounting costs of Medicaid and other health, education, social, and welfare programs are causing financial angst among local, state, and federal government agencies.

What exactly are illegal aliens costing the nation? The last federal report on estimated national costs for illegal aliens was issued on July 25, 1995.

No one wants to touch this hot potato.

James H. Walsh was associate general counsel with the U.S. Department of Justice Immigration and Naturalization Service from 1983 to 1994. Read more reports from James Walsh —
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Administration Advises States to Expand Medicaid or Risk Losing Federal Money

By ROBERT PEAR

Published: October 2, 2012

WASHINGTON — The Obama administration is putting pressure on states to expand Medicaid, telling them they may lose federal money if they delay.

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Jim Lo Scalzo/European Pressphoto Agency

In a ruling, Chief Justice John G. Roberts Jr. said states can’t be forced to expand Medicaid.

But at the same time, federal health officials have also told states that if they choose to expand Medicaid, they are free to reverse the decision at any time.

The officials have set forth their position in letters to state officials — the first definitive guidance since the Supreme Court ruled in June that the expansion ofMedicaid was an option, not a requirement, for states.

The expansion of Medicaid is a major part of President Obama’s health care law, originally expected to account for half of the 32 million people who were to gain coverage. Congress required states to expand Medicaid to cover people under the age of 65 with income less than or equal to 133 percent of the federal poverty level (up to $25,390 for a family of three).

Chief Justice John G. Roberts Jr. said Congress had put “a gun to the head” of states by requiring them to expand Medicaid or risk losing all federal money for their existing Medicaid programs.

“States,” he said, “must have a genuine choice.”

Citing that decision, Cindy Mann, the federal official in charge of Medicaid, said, “A state may choose whether and when to expand, and if a state covers the expansion group, it may decide later to drop the coverage.”

Since the creation of Medicaid in 1965, the federal government and the states have shared the costs. The federal share now averages 57 percent.

Ms. Mann said that while “there is no deadline” for expanding Medicaid, states would pay a price for delay.
Under the new law, she said, the federal government will pay the entire cost of Medicaid coverage for newly eligible beneficiaries for three years, from 2014 to 2016. The federal share will decline to 95 percent in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent in 2020 and later years.

The federal payment rates “are tied by law to the specific calendar years noted,” Ms. Mann said. So if a state defers the expansion of Medicaid to 2016, the federal government will pay 100 percent of the costs for only one year. After 2016, the federal share will drop to the levels specified by Congress, and states will be responsible for the remainder.

“I am hopeful that state leaders will take advantage of the opportunity provided to insure their poorest families with these unusually generous federal resources,” said Ms. Mann, a deputy administrator of the Centers for Medicare and Medicaid Services.

Governors of some states, like Louisiana and Texas, oppose the expansion of Medicaid. Other governors, like those of Illinois and Washington, have said they want to expand the program as Congress intended. In many states, action by state legislatures will be needed to expand eligibility or to authorize the spending of federal money.

In Colorado, State Senator Ellen S. Roberts, a Republican, said she had heard presentations by federal officials who support expanding Medicaid. But she said: “I have no faith in Washington, D.C., to deliver on promises being made to entice states into making these changes. It would be a mistake for us to rush into this.”

Many states that have difficulty paying for their current Medicaid programs are carefully weighing the costs and benefits of changes that could, for some of them, increase enrollment by one-quarter to one-third.
In its guidance to states, the Obama administration left major questions unanswered.

Matt D. Salo, the executive director of the National Association of Medicaid Directors, which represents state officials, said the biggest question was “whether the expansion of Medicaid is all or nothing.”

Some states, he said, may want to expand Medicaid to cover people up to 100 percent of the poverty level, rather than 133 percent.

State officials are asking: Will the federal government pay for newly eligible beneficiaries if a state carries out a partial expansion of Medicaid? Will it pay 90 percent to 100 percent of the costs? Will it pay any of the costs? And if the administration concludes that the new health care law does not allow a partial expansion of Medicaid, will it nevertheless grant waivers allowing states to try such an approach?

The answers may depend on the outcome of the presidential election.

Mitt Romney, the Republican candidate for president, wants to repeal the 2010 health law. He would give each state a lump sum of federal money — a block grant — for Medicaid.

If Mr. Obama is re-elected, most states will expand their Medicaid programs, says a new report from the consulting firm created by one of Mr. Romney’s top advisers, Michael O. Leavitt, a former secretary of health and human services under President George W. Bush.

The report, prepared for the State of Idaho, says: “If President Obama is re-elected, Leavitt Partners believes the administration will do everything in its power to incentivize states to opt in to the full Medicaid expansion, offering program flexibility as needed. Under this scenario, most states will ultimately choose to expand their Medicaid programs, although some Republican states will be slow to move.”

The report adds, “Alternatively, if Republicans take both the White House and Congress, Leavitt Partners believes the administration and Congress will effectively repeal the Medicaid expansion” or reduce the amount of federal money available, so “the expansion will no longer be an attractive option for most states.”

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Federal money is taxpayer money and it is being spent on illegal aliens. JMO