Thread: Illegal Immigrant Language Emerging as Latest Wedge for Heal

Illegal Immigrant Language Emerging as Latest Wedge for Health Debate

Congressional Quarterly Today
December 4, 2009
By Alan K. Ota, CQ Staff

A Democratic split over Senate restrictions aimed at barring illegal immigrants from participating in health care programs has become a potential stumbling block to enactment of a health care overhaul.

Democrats are scrambling to reconcile how the final legislation will handle the nation's estimated 11 million illegal immigrants. Centrists and conservatives favor tough penalties aimed at deterring illegal immigration, while liberals back incentives aimed at helping those already in the country become self-supporting.

The battle previews trouble ahead if Democrats try to pass broader immigration legislation next year. Even in the narrower context of health care, the proposed restrictions in the Senate bill (HR 3590) have been divisive enough to require the White House to step in to prevent the measure from being derailed.

The dispute centers on language from the Finance Committee that would bar illegal immigrants from purchasing health coverage through insurance exchanges the measure would create. Like the bill the House passed Nov. 7 (HR 3962), the Senate version would bar illegal immigrants from receiving federal subsidies to help them buy insurance. But the House version is silent on the question of illegal immigrants purchasing insurance offered through exchanges using their own money.

Finance Chairman Max Baucus, D-Mont., said his approach has the backing of the White House, where officials are well aware that the immigration issue could capsize its top legislative priority. "It's agreed-upon language. I can't say who originally thought of it," Baucus said. "But that's agreed-upon language."

Majority Leader Harry Reid, D-Nev., included the language in the politically calibrated bill he fashioned from versions reported by Finance and the Health, Education, Labor and Pensions Committee.

There are no signs that Baucus' language will be altered during the Senate's ongoing health care floor debate. Democrats realize the bill cannot win the 60 votes needed for passage without the restriction, and Republicans view the language as the best they can hope to see. "In order to get to 60 votes, that's the way it's got to be," said Democratic centrist Bill Nelson of Florida.

But the prospect of language like Baucus' sparked a rebellion in the House by the Congressional Hispanic Caucus that led leaders to oppose including such restrictions in their version. House opponents of tighter restrictions on illegal immigrants' access to insurance contend that President Obama has not taken a position on the dispute, and they promise to carry the fight into House-Senate conference negotiations.

"We're with them on this," said Majority Leader Steny H. Hoyer, D-Md.

In the Senate, the language has stirred a lobbying campaign by constituent groups on both sides of the immigration debate.

Opponents include civil rights groups such as the National Council of La Raza and the League of United Latin American Citizens, while supporters of the tougher language include the advocacy groups Federation for American Immigration Reform and NumbersUSA.

Robert Menendez of New Jersey, the Senate's strongest critic of the ban and the chairman of the Democratic Senatorial Campaign Committee, voted to approve the bill when it was in the Finance Committee, despite Baucus' language. He said he does not intend to try to jettison the language before the Senate passes the bill but would fight to have it removed in conference.

Long a Difficult Issue

Congress has long struggled with how to control the borders and how to provide benefits for the illegal immigrant population that has made it across. In the 1986 immigration overhaul (PL 99-603), Congress coupled leeway for illegal immigrants to become permanent residents with a ban on government benefits.

With prospects uncertain for an immigration overhaul effort during the 2010 election year, lawmakers on both sides of the debate have been reluctant to give ground on access to the health insurance exchanges, since the outcome could have a long-term impact on illegal immigrants.

A recent study by the Center for Immigration Studies, a nonpartisan research group, estimated that roughly 40 percent of undocumented workers had insurance in 2007, mainly provided by employers or the employers of spouses. The changes now contemplated in Congress are not expected to affect them.

But a 2008 study by the Kaiser Family Foundation pegged the annual cost of care for illegal immigrants who lack insurance at $56 billion, with roughly 2 percent of the cost absorbed by insurers and their customers and about 75 percent, or $42 billion, by taxpayers through Medicare and federal subsidies for hospitals.

Democratic Sen. Ben Nelson of Nebraska, a former governor and now a swing vote on health care, supports Baucus' restrictions even though they could create new demands on states if more illegal immigrants seek emergency room and charity care.

"It's true uninsured people, who are here legally and illegally, are a problem when those costs are shifted for everyone else. . . . But I don't think people can accept that illegal immigrants would have access to the exchanges," he said.

For their part, Senate Republicans, including Minority Whip Jon Kyl of Arizona and Jim DeMint of South Carolina, said many in their party support the tougher Senate language and are unlikely to offer amendments on the topic. Charles E. Grassley, R-Iowa, said he has no plan to revive an unsuccessful proposal he made in the Finance Committee to require those seeking insurance in the exchanges to show photo identification.

Opposition From the House

House leaders narrowly won passage of health care legislation in part by quietly lining up with the Hispanic Caucus to oppose the Baucus language.

Xavier Becerra of California, vice chairman of the House Democratic Caucus, teamed up with Democrats Nydia M. Velazquez of New York, Charlie Gonzalez of Texas and Lucille Roybal-Allard of California to warn Obama during an Oval Office meeting Nov. 5 that they would oppose the House bill if language was added mirroring the Baucus provision. Becerra and other lawmakers argued that illegal immigrants should be able to purchase health insurance offered in the new exchanges using their own money to keep them from ending up in emergency rooms, causing costs to spiral.

Whatever happens in the Senate, House members insist they will oppose a final bill if a conference report restricts illegal immigrants from buying insurance with their own money.

"What's next?" asked Raul M. Grijalva, D-Ariz., co-chairman of the Congressional Progressive Caucus. "Will they ban some undocumented person from buying a burger?"

Velazquez, chairwoman of the Hispanic Caucus, said she and many of the other 20 members of the caucus plan to oppose any final bill containing such restrictions.

John Yarmuth, D-Ky., who serves as a strategist for Speaker Nancy Pelosi, D-Calif., on health care, said he expects the White House to push for tougher restrictions on the participation of illegal immigrants and offer to "solve the problems next year" as part of an immigration overhaul. But he added that such an argument is unlikely to sway critics of the Baucus provision because of the uncertain prospects for an immigration overhaul next year.

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"What's next?" asked Raul M. Grijalva, D-Ariz., co-chairman of the Congressional Progressive Caucus. "Will they ban some undocumented person from buying a burger?"

"What's next?" asked Raul M. Grijalva, D-Ariz., co-chairman of the Congressional Progressive Caucus. "Will they ban some undocumented person from buying a burger?"

Now that is sheer, stupid drama, Rep. Grijalva. There are explicit laws banning illegals for producing and selling that burger, but how many of your illegal constituents are doing exactly that?

Illegal immigration is one of the biggest reasons why lawmakers are pushing for health reform. Big business and unions dont want to pay for health care when and if illegal aliens are given amnesty. So they decided to redo everything and make us pay for it. I've been watching the debate on c-span. Bacus and Reid both look sinister and evil to me. They would make good extras in Friday the 13th or some other horror movie.

At the present time, there is nothing that prevents illegals from purchasing health insurance. They choose not to in order to have more money to send to their home country. Why bother when everything is free at the local emergency room.

Originally Posted by ReggieMay

At the present time, there is nothing that prevents illegals from purchasing health insurance. They choose not to in order to have more money to send to their home country. Why bother when everything is free at the local emergency room.

I think the reason this is such an important point is that if IAs are allowed to purchase they must also be allowed the means test that will let the poor obtain it for nothing or next to nothing.