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From the Fact Check Desk: Illegal Immigrants and Health Care Reform

September 10, 2009 5:43 PM

Defending his reasoning, if not his outburst, today Rep. Joe Wilson, R-SC, declared that “the Congressional Research Service has indicated that indeed the bills that are before Congress would include illegal aliens.”

What Rep. Wilson had so bluntly yelled was a “lie” last night was a different assertion; President Obama had said, “the reforms I’m proposing would not apply to those who are here illegally.” In other words, the president had changed the debate from any specific legislation to what he was proposing – and, indeed the White House last night posted a 2 ½ page legislative outline called “The Obama Plan” on its website, which as of today seems to be the only plan White House officials are willing to discuss or defend.

But be that as it may, we decided to take a look at the August 26 Congressional Research Service report "Treatment of Noncitizens in H.R. 3200," the House bill. (You can read a copy HERE.)

The non-partisan analysts conclude that:

*             some illegal immigrants -- those who "meet the substantial presence test" -- would be taxed if they don't obtain health insurance that meets the requirements of the law;

*             there are no immigration-related restrictions on who can participate President Obama’s proposed health insurance exchanges;

*             to qualify for any subsidies for health insurance, "individuals must be lawfully present in a state in the United States." That does not preclude those in this country legally who have illegal immigrants in their family from qualifying for the subsidies.

*             how will the government make sure that subsidies don't go to illegal immigrants? The mechanism is left entirely up to the Health Commissioner, who is instructed by law that he or must have some process to establish immigration status before giving subsidies. Sec. 241(b)(1), pg 130 : “the Commissioner shall establish a process whereby, on the basis of information otherwise available, individuals may be deemed to be affordable credit eligible individuals."  That “shall” is key.
 
The one way the H.R. 3200 could end up in more health care being provided to illegal immigrants by taxpayers comes from the expansion of Medicaid.

Illegal immigrants are already eligible for emergency care through the Emergency Medical Treatment and Active Labor Act, signed by President Reagan in 1986. This emergency care is often paid for by Emergency Medicaid, private insurance if the patients have it, out-of-pocket, or it's written off as bad debt or charity care by the hospital.

H.R. 3200 would extend Medicaid coverage up to 133 1/3% of poverty for populations that previously were not covered such as some parents and childless adults.

That expansion could – could -- mean more illegal immigrants would become eligible for Emergency Medicaid.

Which is not to say that citizens don't pay for those costs anyway through extra hospital fees, but this would clearly be a more direct billing to the taxpayer.

**

As long as I have your attention, I should point out that all of us already pay the costs of health care for illegal immigrants -- through emergency room visits, Emergency Medicaid, hidden fees by hospitals, workplace safety incidents, and the like. This idea that we all aren’t paying for this one way or another is non-reality-based.

**

But back to the fact check desk: do President Obama’s proposed reforms apply to those in the U.S. illegally?  No.

To recap on what CRS says: Does the House bill provided subsidies to illegal immigrants? No.

Would the House bill require illegal immigrants to have health insurance? Some of them, yes.

Would the House bill allow illegal immigrants to purchase health insurance in a health insurance exchange? It doesn’t restrict it, though White House press secretary Robert Gibbs today said he didn’t think the version of the law the president would sign would allow such a thing.

Could the House bill expand emergency Medicaid laws as they already exist, perhaps – perhaps -- expanding coverage for illegal immigrants in keeping with current law?

According to CRS: Yes.

-jpt

September 10, 2009 | Permalink | Share | User Comments (450)

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first of all why are you ppl sayin from the border like all the immigrants are from mexico. It took my dad 12 years to become an american citizen because of all the paper work and he came over here the right way by bein an exchange student. Who is to say that he got hurt and had to go to the hospital during thoughs 12 years. would you deny him...now an american citizen who was fightin for a better life and freedom

Posted by: stephanie | Oct 6, 2009 11:07:23 AM

Whoever introduces an ammendment to put the illegal aliens on the healthcare reform should be prosecuted for attempting to aid and abet a crime of being an illegal and you could add conspiracy.

Posted by: grasp | Sep 28, 2009 3:57:28 PM

hey , shhhhhh, stop fighting,we need then more than you think. just google “SS SUSPEND FILE”
wow

…Starting in the late 1980’s, the Social Security Administration received a flood of W-2 earnings reports with incorrect - sometimes simply fictitious - Social Security numbers. It stashed them in what it calls the “earnings suspense file” in the hope that someday it would figure out whom they belonged to.

The file has been mushrooming ever since: $189 billion worth of wages ended up recorded in the suspense file over the 1990’s, two and a half times the amount of the 1980’s.

In the current decade, the file is growing, on average, by more than $50 billion a year, generating $6 billion to $7 billion in Social Security tax revenue and about $1.5 billion in Medicare taxes.

In 2002 alone, the last year with figures released by the Social Security Administration, nine million W-2’s with incorrect Social Security numbers landed in the suspense file, accounting for $56 billion in earnings, or about 1.5 percent of total reported wages.

Social Security officials do not know what fraction of the suspense file corresponds to the earnings of illegal immigrants. But they suspect that the portion is significant.

“Our assumption is that about three-quarters of other-than-legal immigrants pay payroll taxes,” said Stephen C. Goss, Social Security’s chief actuary, using the agency’s term for illegal immigration.

Other researchers say illegal immigrants are the main contributors to the suspense file. “Illegal immigrants account for the vast majority of the suspense file,” said Nick Theodore, the director of the Center for Urban Economic Development at the University of Illinois at Chicago. “Especially its growth over the 1990’s, as more and more undocumented immigrants entered the work force

Posted by: razor1 | Sep 25, 2009 9:14:04 PM

John Galt writes: "No one can dispute those facts about emergency medical care and services to illegal's. Do you have a suggestion to resolve this issue? Do we stop it all together and let many of them die or get worse? Do we send them back to their country of origin (at who's cost) so they can be treated in their own country, or do we attempt to charge back towards their countries medical systems at our costs? Do we than ship these illegal's back to their own countries. I hear a lot of complaints from all sides here but see no real solutions. Ideas?"

How about just enforcing the immigration laws we already have?
Why would that cost us anything more?

If no one can employ, house or provide aid to an illegal alien, the problem will quickly solve itself.
Because, most illegal aliens would be forced to self-deport.

Some minor adjustments might have to be made to our criminal laws, of course.
Requiring the mandatory death penalty for illegal aliens found guilty of a capital crime, is a good example.

And for lesser crimes, deportation would have to be a part of the sentencing, once they've served the appropriate jail-time.

Then, all we'd have to do is guard our borders -- something we're supposed to be doing, anyway.

Posted by: jolou1 | Sep 21, 2009 12:46:43 PM

Robert writes:
"Republicans are pro-life and anti-healthcare. What? What did that dirty little fetus ever do to contribute to society? :P"

In some cases, Robert -- not a thing.

But, here's one for you to analyze --
I'm a "pro-life," Christian, who staunchly supports the death penalty.

So, what has any of that to do with a particular political party?
Nothing!
It's simply common sense.

Posted by: jolou1 | Sep 21, 2009 11:59:32 AM

Republicans are pro-life and anti-healthcare. What? What did that dirty little fetus ever do to contribute to society? :P

Posted by: Robert | Sep 20, 2009 4:17:13 PM

James wrote:
"maybe the wealth sharing should be shared with the work"

It absolutely should, James.
And yes, Obama is targeting our
middle class.
That's because socialism cannot be implemented until the middle class has diminished into total poverty.
Because, socialism has room for only two classes -- the impoverished, and a select handful of reigning elite.

A large middle class is not only fit enough to rebel against tyranny, but also has the most to lose.
Yet, even the working poor, with little to show for their labor, might still take pride in what they've managed to accomplish.

Because poverty isn't shameful.
But becoming resigned to stay in it, blaming others for it, or expecting others to pay you out of it -- is.

And you're right about giving, James.
Unless one has enough to share, how is he even capable of doing so?

So, your comment about "the nanny state" is right on point.
Obama would like nothing better than to be the source of all of our needs.

Because, that's what gives the socialist dictator power over everyone else.
He controls all of the necessary commodities, choosing when they are to be redistributed, in what quantities, and to whom.
And health care is certainly one of those commodities!

So, is it any wonder that the "redistribution of wealth" has been one of Obama's most highly promoted goals?
Or, that some of the world's dictators are among his most honored acquaintances?
He studies them, you see.
However, he doesn't seem to realize that the peoples they've managed to enslave...
weren't Americans. ;)

Posted by: jolou1 | Sep 15, 2009 1:24:09 AM

Liz, I agree with your well-written post.

Posted by: Lydia | Sep 14, 2009 11:36:06 PM

i own a small bussiness with 7 employees and if any file for a credit for insurance i will be charged 400.00 for each employee if only 1 applies.7x4 =2800.00 . 2800.00 out of my small business means 2 people hit the street unemployed.iam tired of paying everbodys way.each day that goes by gets tougher on the little man.my deductiable is 3000.00 just so i can pay 900.00amonth for my wife and i to have insurance.the american way i say no way! the bs president we have is an idiot. tax the middle class and give it to everybody else. sure i love to work 15 hrs a day 7 days a week and share the wealth.maybe the wealth sharing should be shared with the work.we dont need a nanny state, im tired of all this bs.the government has on its mind.its time the people have a say

Posted by: james | Sep 14, 2009 7:33:07 PM

Wow. Whoever's proud of this country's "core values" clearly doesn't give a damn about their fellow human being. This country was built on genocide, assimilation, appropriation and GREED. The "land of milk and honey" that accepts "the tired, the weak the poor" is a myth. Sure, we wanna bring 'em in, but then we want to exploit them and use them for cheap labor - all the while complaining that immigrants are the downfall of our economy. Do any of you have any real clue of what would happen to this country if suddenly every immigrant were made to go back from whence they came? Do you?
Just because Obama spent his formative years doesn't mean he has no clue about American history, and to say so is absolutely absurd. Perhaps American students - under our rapidly diminishing educational systems - wouldn't understand the history of other cultures - but plenty of educated people from other countries know more about the history of America than our own citizens. You're in some serious denial of you don't agree.
It's about time someone stepped in to "change our history." Our history is shameful. Ever read "Lies My Teacher Told Me"? Ever talked to a Native American about their experience in this country, or the history their forefather taught them? Try learning "reality" from others' perspectives, and not staying within your own CLEARLY limited box.
Nothing Obama is doing is radical, but certainly it's drastically different. We need the change. Frankly, I wish he were more radical with his decision-making and not so quick to cow to the cold right-wingers who care more about acquiring wealth no matter who they have to step on to get it than providing help for those in greater need.
Some of you need to do some REAL research (hint: FOX news isn't it) and stop thinking of things from pseudo-Patriotic, moralistic perspectives. It's amazing, you people can have the facts right in front of you and still ignore it. Unbelievable.
YOUR game and YOUR board is being threatened, sweet cheeks. "Minorities" are no longer in the minority, poor people are finding a voice, and humanitarianism is on the rise. Look out!

Posted by: Liz | Sep 13, 2009 6:14:17 PM

DJH writes: "2012? it cannot get here soon enough. Obama has been a far bigger disaster than most of us thought. The man doesn't think or act like an American president - he doesn't love this country, he loves what he wants to turn this country in to and his policies betray ever core value this country holds dear. He can't be run out of town on a rail fast enough for the majority of Americans."

Well said, DJH!
Obama doesn't think or act like an American president, because he simply has no idea what it means.
He spent his formative years under a foreign educational system. He hasn't a clue about American history. And so, as even his own wife said, publicly -- he plans to "change" our history.
Yes, she actually said that.

Indeed, the Obama's are radical left revisionists.
They even hope to expand that ideology, to include "changing" our past, as well as socializing our future.
Don't laugh -- it's been done before.
And Obama does have some knowledge of world history. He fully understands the indoctrination of the young, and the stupid.

So, DJH, joedoe, Freedom, and the rest of you here who can see the real Obama agenda -- know that you are NOT in the minority!
This is still OUR game, being played out on OUR board....and we're very familiar with the Founding rules.

Join one of your local patriot groups!
If you haven't any, locally -- start one!

Posted by: jolou1 | Sep 13, 2009 4:33:44 PM

Jeanna writes: "The gathering in Minnesota for Obama today makes the tea party in Washington look like a backyard little girl tea pary."

Oddly enough, the StarTrib is reporting that only about 17,000 were in attendance for Obama's "pary,",' Jeanna.

We had over 18,000 for our recent LOCAL tea party -- our fourth one, and growing bigger, with each gathering!

Furthermore, the D.C. 9-12 Rally consisted of between 75,000 and 100,000 marchers.

And guess what?
Many of those "little girl" 9-12ers even brought their parents with them!

You may be a nurse. But, if that's your best shot at simple mathematics -- no thanks! I'll take my shots from a nurse who can accurately measure cc's.

Posted by: jolou1 | Sep 13, 2009 3:31:04 PM

Check out my 3 minute commenatry on the healthcare debate. Don't forget the uninsured

I am very saddened by the selfish tone of the healthcare debate. More people seemed worried about theorectically loosing what they have than with the reality that many don't have any insurance at all. What do you think?

Watch my commentary here: LTH WEEKLY

George C

Posted by: George | Sep 13, 2009 2:50:32 PM

This illegal immigrant issue has now been dealt with from news reports I have read. Individuals must produce identification to get coverage. At present I am still checking validity of report I read. But all indications do indicate bill has more strict rules now.

As for Joe Wilson. He is/was wrong. And I do find his post incident actions/statements still inappropriate. I am a 65 yo white female college educated professional and am embarrassed of/by Joe Wilson statements/actions.

Posted by: Sharon | Sep 13, 2009 1:46:55 PM

dlboggan writes: "But, how do we take the chaos out of the ballooning costs created by a unregulated and poorly controlled profit based health coverage and services including pharmaceuticals?"

Let me guess -- turn the controls over to another unregulated, chaotic group...who have completely forgotten who they work for?
And are you, by any chance, one of them?

dlboggan also writes: "We cannot just let the profits and services go where ever they want it to..."

I had to read that one a few times.
I think everyone here should.

I'm curious, though.
Just what is it about "profit" that so frightens people like Obama..and the Castros...and Chavez....and you?

Posted by: jolou1 | Sep 13, 2009 1:43:29 PM

Jeanna writes:"I was going on these blogs everyday, to make sure our leaders know there are a lot of pro reform people out here."

Just one question --
how many mice do you have in your pocket?

There's an old saying...something about 'the squeakiest wheel' getting the most grease.
Well, Jeanie...unless you're adept on the unicycle, I suggest you pay attention to what the other wheels currently carrying your butt are doing.

Real Americans have had about all we're going to take from you squeaky wheels.
This isn't Europe.

Posted by: jolou1 | Sep 13, 2009 1:06:06 PM

What part of they already get free care is so hard for you guys to understand?

It's stupid to argue against them actually paying something into this. It would save us money.

Posted by: Secondlook | Sep 13, 2009 12:08:24 PM

Wilson already apologized. That is enough. Wilson was right. The Democrats want to provide health coverage to illegal aliens. I believe, Americans and legal permanent residents must show documents such as US birth certificates; US passports; or certificates of naturalization to prove they reside in the United States legally. Or they can show a valid social security card (SSC). I say a valid SSC because illegal aliens use fake SSCs.

Posted by: Patty | Sep 13, 2009 10:19:52 AM

Don't try your stupid double speak on us. We know that argueing details instead of fixing loopholes is the agenda and the purpose is to not pass the one thing most citizens want, and that is the public option. Anti-reformists are using every trick they can to block the public option, but we are not fooled. If public option is not in the bill, those who blocked it will not have public service in their future.

Posted by: Jeanna | Sep 13, 2009 10:10:52 AM

When working under the CNO I learned that in contract law, a contract is most often brought to bear against the writer.

The rationale for this is that the writer had an inordinate amount of time to write the document, whereas the other party had less time to review the document.

That being the case, why would the 1018 page house bill be so confusing? how could it possibly be misunderstood? How can it be even remotely presumed to mean something different that what it implies?

We who oppose the bill are not creating myths, we are just reading it and wondering why these controversial items are so apparent, yet supposedly are products of our imagination?

Whatever is written by a congress that fails to hear us is likely to be bastardized into whatever the ACLU and others might later want it to mean. Consider what the ACLU and the courts have done to bastardize the First Amendment, and seemingly gotten away with it!

Posted by: Ed Taylor | Sep 12, 2009 9:35:12 PM

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