Report Sees Implications for Reform Legislation’s Handling of Immigrants
Several "vexing" questions could be raised if lawmakers prohibit undocumented immigrants from accessing health coverage under a new health insurance system resulting from health reform legislation, according to a report released on Monday by the Congressional Research Service, CQ HealthBeat reports.
Lawmakers currently are considering how to address various issues involving undocumented immigration in reform bills.
The Senate Finance Committee bill (S 1796) would exempt undocumented immigrants from a personal mandate to have health insurance and would bar them from taking part in health insurance exchanges.
The Senate Health, Education, Labor and Pensions bill (S 1679) and the House bill (HR 3962) would allow undocumented immigrants to partake in the exchanges if they use their own money to purchase insurance.
However, all three bills would make undocumented immigrants ineligible for federal subsidies that would help low- and moderate-income U.S. residents purchase coverage. As a result, many undocumented immigrants would forgo health coverage because many have low incomes, according to CRS.
The report notes that 23.4% of non-U.S. citizens have annual incomes below the federal poverty line and 28% have incomes of between 100% and 199% of FPL.
The report raised questions regarding undocumented immigrants in the context of health reform proposals, including:
- "Will health care providers be less likely to provide medical treatment to uninsured people whom they presume are likely to be unauthorized aliens?"
- Would undocumented immigrants be able to underbid U.S. residents in the labor market if they are exempted from the insurance mandate, particularly among private contractors and self-employed residents?
- Would U.S. resident children in a "mixed-status" immigrant family be less likely to benefit from federal subsidies for care if they have an ineligible parent?
- Should U.S. residents who sponsor documented immigrants be required to assume some responsibility for the new residents' insurance costs?
- Should the current five-year ban on federal means-tested benefits for documented immigrants also apply to subsidies for health insurance premiums? (Norman, CQ HealthBeat, 11/3).
More Questions About Documented Immigrants
Meanwhile, lawmakers also are debating how much coverage to provide for documented immigrants, the New York Times reports.
According to a study by the Migration Policy Institute, more than one million documented immigrants would have no health insurance under certain reform proposals currently being considered by Congress.
The issue is drawing a lot of interest in California, where public health researchers have voiced concerns about how many documented and undocumented immigrants reform proposals would leave uninsured.
A study by the UCLA Center for Health Policy Research estimates that California would have the largest population of uninsured residents under current reform proposals.Â Those numbers would include as many as 1.4 million documented and undocumented immigrants.
While Democrats generally agree that undocumented immigrants should be prohibited from receiving federal benefits, many want documented immigrants to be able to participate in proposed insurance exchanges and receive subsidized coverage if they qualify.However, some Republicans are seeking to exclude from benefits immigrants who have been living legally as permanent residents for fewer than five years. Some GOP lawmakers also argue that strengthening restrictions on documented immigrants, in addition to undocumented immigrants, would reduce federal expenditures and prevent health benefits from becoming incentives for other migrants to come to the U.S. (Preston, New York Times, 11/4). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.