MEDICAID: IMMIGRANTS MAY BE CUT FROM NURSING HOMES
Nursing homes across the country are reviewing theThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
immigration status of applicants for admission and "expect to
exclude many elderly immigrants who will become ineligible for
Medicaid because of the new welfare law." NEW YORK TIMES reports
that since President Clinton signed the welfare reform bill
August 22, Medicaid is now unavailable to most immigrants
entering the U.S. Many nursing home residents receive Medicaid
benefits because they receive Supplemental Security Income.
However, the new welfare law eliminates Supplemental Security
Income eligibility for most legal immigrants. Permanent resident
aliens are exempt from the benefits ban if they or their spouses
or parents have worked in the U.S. for ten years. However, the
TIMES reports that it may be difficult for non-English speaking
immigrants or those who were paid off the record to document
their work history.
DETAILS: The welfare reform law is designed to save the
federal government $54.6 billion over six years. The
Congressional Budget Office said that about 44% of the $54
billion in savings would come from restricting benefits to
immigrants. NEW YORK TIMES reports that Congress, in
anticipation of legal challenges, "has justified the restrictions
as the best way to achieve 'the compelling governmental interest
of assuring that aliens be self-reliant in accordance with
national immigration policy.'"
THE NUMBERS: NEW YORK TIMES reports that the government
does not have accurate data on the number of immigrants living in
nursing homes because in the past, "the homes had no particular
need to collect and update such information." LuMarie Polivka-
West, policy director for the Florida Health Care Association,
said that the nursing home restrictions could affect 2,880
immigrants in the Miami area alone. Gary Macomber, executive
vice president of the California Association of Health
Facilities, said that about 12,000 to 15,000 of the state's
100,000 nursing home residents are legal immigrants." He said,
"We don't know what the state Legislature will do, but it's our
impression that many of them will eventually lose their
coverage." New York State Health Facilities Association
Executive Director Edward Stafford said that nursing homes "are
very hesitant to admit anyone if they're not sure he or she is a
U.S. citizen. ... [O]bviously health care facilities can't afford
to provide free care" (Pear, 10/13).
LEGAL CHALLENGE: California Gov. Pete Wilson's (R) move to
end publicly funded prenatal care for illegal immigrants "has
spawned one of the first flurries in what probably will become a
nationwide blizzard of litigation" as a result of the welfare
reform law. Advocates for immigrants will seek a hearing in U.S.
District Court in Los Angeles today "to argue that the threatened
cutoff in prenatal care would violate the existing injunction
against Proposition 187, the 1994 ballot initiative targeting
illegal immigrants" (see AHL 12/8/94). And, across the nation,
"teams of public interest lawyers, aided by pro bono private
attorneys, are busily studying relevant appeals court decisions
and combing social-service agencies for prospective test-case
plaintiffs." LOS ANGELES TIMES reports that the prospective
lawsuits would target "not just the provisions related to legal
and illegal immigrants, but also sections of the welfare law
affecting U.S. citizens."
CALIFORNIA LAW: LOS ANGELES TIMES reports that "[m]uch of
the legal drama is expected to play out in California, where
Wilson has vowed speedy implementation of all provisions
affecting illegal immigrants." Legal activists contend that
Wilson's effort "is a backdoor scheme to implement a key
provision of Proposition 187." The provision would eliminate
care to pregnant women whose children would become U.S. citizens
at birth. Some immigration advocates "acknowledge" that "one
goal of the suits would be to delay implementation of the law in
hopes that Democrats will regain control of Congress and scuttle
much of it" (McDonnell, 10/15).