Thread: New law will give young legal immigrants access to health ca

New law will give young legal immigrants access to health care

By Guy Boulton of the Journal Sentinel

Posted: Feb. 14, 2009

Since 1996, children who are legal immigrants have not been eligible for state health programs, such as BadgerCare Plus, for their first five years in the country.

That will change under a new law that will expand health care coverage for children whose families make too much money to qualify for existing programs but too little to afford health insurance.

The law, signed this month by President Barack Obama, will allow states to use federal money to provide health insurance to low-income children who are legal immigrants.

In Wisconsin, where the state statute is tied to the federal law, children in low-income families will automatically become eligible when the law takes effect in October.

The new law does not apply to children who are in the United States illegally. But it touches on one of the overlooked issues in health care reform: the 10 million to 12 million immigrants who are among the 47 million people estimated to be without health insurance at a given point in time.

It also touches on an explosive issue - illegal immigration.

Although the law will affect relatively few children in Wisconsin, some see it as symbolic.

"It's says something about what kind of society we are - how do you take care of children?" said Annie Janisch, a social worker at Sixteenth Street Community Health Center.

The state Department of Health Services does not have an estimate on how many children in Wisconsin are low-income legal immigrants who have been in the United States less than five years. But the state does not expect a large influx of children in the BadgerCare Plus program, said Jason Helgerson, who oversees that and other Medicaid programs.

Also, the federal government will pay roughly 72% of the cost of insuring the children.

Based on a rough estimate, 3,700 to 5,500 children in Wisconsin are legal immigrants who would be eligible for coverage, said Leighton Ku, professor at the George Washington University School of Public Health & Health Services.

He estimates that nationally, 400,000 low-income children are legal immigrants.

Some of those children may have health insurance through an employer. And some states, including Illinois and Minnesota, already provide health insurance to children who are legal immigrants. Those states now will receive federal money to offset the cost of insuring those children.

Most children of legal and illegal immigrants - 75% to 80% - are born in the United States and are citizens. The percentage is higher for children under the age of 6 - an estimated 93% are U.S. citizens.

Randy Capps, a senior policy analyst with the Migration Policy Institute in Washington, D.C., said the new law will mean less confusion for low-income immigrant families with children.

"If you are here legally, you get health care coverage," Capps said. "That's the virtue of this change. It's just so much simpler."
'Hot-button issue'

Still, few issues evoke stronger emotions than illegal immigration. And a widely held belief is that immigrants - legal and illegal - are eligible for health programs such as BadgerCare Plus and Medicaid.

That is not correct, with two exceptions.

Illegal immigrants are not eligible for BadgerCare Plus. And legal immigrants must wait five years before they are eligible.

One of the exceptions is pregnant women. They are eligible for prenatal care in Wisconsin. The rationale is the child will be a U.S. citizen and that providing prenatal care saves money in the long run by preventing costly premature births and other complications. Shortly after the child is born, the mother loses her coverage.

The other exception is Medicaid funds available to hospitals that provide emergency care to legal and illegal immigrants. The rationale here is that hospitals are required by federal law to provide emergency care.

Even that is controversial.

A survey by the Los Angeles Times/Bloomberg in 2007 found that one-third of 1,245 people responding supported denying social services, including emergency medical care, to all immigrants.

"For many people, when you say immigrants, they automatically assumed they are undocumented," Ku said.

There are an estimated 38 million immigrants in the United States. Using census data for 2005, the Pew Hispanic Center estimated that:

• 31% were naturalized citizens.

• 38% were legal non-citizens.

• 30% were illegal immigrants.

Regardless of their status, young low-income children of immigrants are twice as likely to be uninsured as those of natives. The rate is even higher for adults. By one estimate, 49% of legal and illegal non-citizens are without health insurance.

Yet immigrants also are often ignored in the debate about providing universal health insurance.

"People realize it is a hot-button issue," Ku said.

But he noted that people often feel differently about children

"We are talking about legal kids here," he said of the new law. "That's the bottom line."
Emergency care

Perhaps for that reason, the new law has sparked little controversy. More criticism was directed at allowing states to change the way they verify citizenship.

"In no case should we use the health care system as a weapon to combat illegal immigration," said Robert Moffit, a health policy analyst with the Heritage Foundation, a policy research group in Washington.

Moffit, who supports stopping illegal immigration, noted that the issue can't be separated from physicians' ethical guidelines.

"Certainly, we are not going to turn people who are very ill away from emergency rooms," he said.

That immigrants are flooding hospital emergency departments is another widely held belief. But research shows that non-citizens are significantly less likely to get care from hospital emergency departments than citizens, and that much of the increased use of emergency departments comes from people with insurance, according to the Kaiser Commission on Medicaid and the Uninsured.

Children's Hospital of Wisconsin does not track patients by immigrant status and does not have figures on how many children who are legal or illegal immigrants it treats.

But Peggy Troy, the new chief executive of Children's Hospital and Health System, said that "kids are kids."

"We are going to take care of them," said Troy, who supported the new law on children who are legal immigrants.

So, too, did advocates for expanding health insurance coverage for children.

"Five years is a lifetime to a kid," said Jon Peacock, research director of Wisconsin Council on Children and Families, a research and advocacy organization.

Gov. Jim Doyle has the stated goal of providing heath care to all children in the state, Peacock noted. The new federal law will help.

"It gets us that much closer," he said.
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Who loves our government?

Im not giving the Government so much as a nickle unless they threaten me with execution. They can go <blank> themselves.

At there are some people diffentiating between legal and illegal immigration. And I thought it was federal law that hospitals are not allowed to ask immigration status before treating a patient. They are only allowed to ask about insurance. They usually need a SSN, but whether it is real or not is none of the hospital's business. They should also have access to E-Verify!