As the health care debate moves forward, the Senate should not make bogeymen of immigrants

By Chung-Wha Hong

Wednesday, November 11th 2009, 4:00 AM
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It was a squeaker, and could well have ended in a debacle, but the House succeeded at passing an imperfect but nonetheless historic health reform bill on Saturday. As the debate moves to the Senate, there are some lessons we can learn from how it played in the House. Let's look at one aspect of the debate: the use of immigration to block the road to health reform.

In the current climate, a resolution to our nation's health care crisis can come very close to being derailed by the cynical use of wedge politics.

Fortunately, the House averted that and got a bill passed, although not for lack of trying on the part of health reform foes. In the end, their attempts to bring in such wedge issues as immigration to stop health reform in its path were exposed as the desperate measures they are. The Senate should keep this in mind.

Holding out immigrants as the bogeymen in the debate doesn't hold water. Undocumented immigrants are currently excluded from public insurance programs like Medicaid, and the House and Senate versions would continue that exclusion. Furthermore, undocumented immigrants would be excluded from any federal subsidies, such as affordability credits. But in its zeal to score points by feeding into the public's frustration with illegal immigration, the Senate Finance Committee has gone further, including an absurd provision that would bar undocumented immigrants from using their own money to buy coverage at full price through the exchange. This provision runs counter to a basic tenet of health reform, which is that you can reduce costs and expand coverage by having more people pay into the system. Fortunately, the House rejected this provision. (Rep. Nydia Velázquez of Brooklyn deserves credit for doing the political heavy lifting to block it). The Senate should come to its senses and reject it as well.

Verification measures shouldn't block or delay care for the eligible. So much attention has been paid to, as Sen. Kent Conrad (D-N.D.) says, "prevent\[ing\] anyone who is here illegally from getting any federal benefit." In pursuit of this objective, however, it's important for policymakers to let experience be their guide.

In 2005, the federal government instituted verification procedures to ensure that only citizens and eligible legal immigrants access Medicaid, even though undocumented immigrants have always been excluded from the program. The cost of this verification? A House oversight committee study found that in just six states, it cost the federal government $8.3 billion.

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What a load of crap that last paragraph is.

Oops there's a page two:

The impact? It mostly resulted in care being delayed or denied to eligible U.S. citizens and legal immigrants, and it identified only eight undocumented immigrants. Once a bill gets hammered out in conference and regulations implemented, there's no room for onerous verification requirements that are costly, inefficient, disingenuous and contrary to the goals of health reform.

A no-brainer: Health reform legislation must include provisions that further the goals of health reform. A good place to start is by repealing the federal provision, in place since 1996, that has barred legal immigrants from Medicaid during their first five years here - barred from the very program their tax dollars support.

The result of this bar? Low-income legal immigrants - who often work in jobs without insurance - are forced to delay care until their conditions worsen. This makes no sense, and reversing it is something the public could support. In fact, a statewide poll last spring found that 83% of New Yorkers believe that if you pay the same taxes, you should get the same services. (And New York and 12 other states have long recognized the public health interest in extending Medicaid to all eligible legal immigrants by using state money to cover it.) The House bill glaringly omits a provision to reverse the five-year bar. The Senate needs to take it on.

When President Obama signs a health reform bill, it must be a vehicle, pure and simple, for health reform. The last shot we had at health reform was nearly a generation ago; if we don't get it right now, the opportunity won't be there to fix it anytime soon.

We need strong leadership in this fight, leadership that also can pave the way for providing solutions to other critical issues facing the nation, including immigration. But this bill is not the vehicle for addressing immigration, and Congress and the President must stand firm against acquiescing to myriad counterproductive measures. Such acquiescence is the politics of sheep; what we need now are shepherds to move real health reform forward.

Hong is executive director of the New York Immigration Coalition.

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