Thread: Health Care Debate Focuses on Legal Immigrants

Health Care Debate Focuses on Legal Immigrants

New York Times
By JULIA PRESTON
November 3, 2009

The debate over health care for illegal immigrants continues to percolate in Congress despite the Obama administration’s efforts to put it to rest, with lawmakers in both houses also wrangling over how much coverage to provide for immigrants who have settled in the country legally.

Some Republicans favor excluding immigrants who have been legal permanent residents for less than five years, as well as all illegal immigrants.

Democrats broadly agree that illegal immigrants should be excluded, but many want all legal permanent residents to be able to participate in proposed health insurance exchanges and receive subsidized coverage if they qualify.

Latino leaders, worried that Congress might quietly cut back benefits for legal immigrants, have started an 11th-hour campaign to eliminate waiting periods for them in the proposed legislation and to cancel the existing five-year wait for Medicare and Medicaid programs.

Under some plans being considered by Congress, more than one million legal permanent residents and about seven million illegal immigrants who currently have no health insurance would be excluded from coverage, according to a study by the Migration Policy Institute, a nonpartisan research group in Washington.

Any proposal under discussion would leave California with the largest population of uninsured residents, as many as 1.4 million legal and illegal immigrants, according to a study by the Center for Health Policy Research at the University of California, Los Angeles.

California’s health system has been crippled by the soaring costs of caring for 6.8 million residents with no insurance, a figure that includes about 4 million American citizens.

Large numbers of immigrants in Florida, New York and Texas would also remain without coverage under the proposals.

While generally ceding the fight to gain coverage for illegal immigrants, groups like the American Hospital Association, the United States Conference of Mayors, and the Catholic Health Association, among others, have urged Congress to eliminate any waiting periods for legal residents in future programs and for Medicare and Medicaid. Such exclusions, they say, tend to defeat the cost-saving purposes of universal coverage.

“You can either keep those immigrants healthy now, or exclude them and wait until they get really sick, then pay for it down the line,â€

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