Complaints that those in the United States illegally would get benefits under the health-care bill now before the House of Representatives have been a staple of the raucous public meetings some members of Congress have been hosting during their August break. At least two people raised the issue at a forum held by Sen. Ben Cardin, D-Maryland, on August 12, and Cardin's insistence that "Illegal aliens will not be in this bill - period - the end" was met with a round of jeers.
The bill, HR 3200, would set up a health insurance "exchange," in which consumers could compare policies and choose a plan. It would create a government-run health plan to compete with private insurers in that exchange, and extend subsidies for coverage to people who aren't already covered by employers or federal programs like Medicare and Medicaid. It specifically bars illegal immigrants from receiving those subsidies. Section 246, which is included in the part of the bill that sets up the exchange, forbids payments "on behalf of individuals who are not lawfully present in the United States."
But when Cardin said undocumented workers "will not be in this bill," he appears to have missed one point: It may require them to buy their own coverage.
That's the conclusion of the Congressional Research Service, which issued a report on the topic. According to the CRS, noncitizens who can be considered "resident aliens" under U.S. tax law would have to buy insurance - and unlike immigration laws, the tax code doesn't distinguish between legal and illegal immigrants.
"Thus, legal permanent residents, and noncitizens and unauthorized aliens who qualify as resident aliens ... would be required under H.R. 3200 to have health insurance," the new report states.
Critics say there is no way to enforce the ban on subsidies for undocumented workers, since the Democratic majority in the House turned back a Republican effort to explicitly stiffen citizenship checks. But Medicare and Medicaid already require those enrolled to provide "a substantial number of documents" to show they're U.S. citizens or legal residents, said Henrie Treadwell, a professor of community and preventive medicine at Atlanta's Morehouse University medical school.
Treadwell calls the issue a "red herring," since many of the estimated 10 million to 12 million illegal immigrants in the United States are getting treatment at emergency rooms already. Doctors are obligated to treat people who show up regardless of citizenship, and most of those costs are being absorbed by hospitals and state and local governments, Treadwell said.
"It is certainly not just something that disappears," she said. "We are paying now for care that is not preventive, and we are paying millions."
Some Republicans argue that the measure has left a loophole for undocumented relatives of legal residents to be covered. But Treadwell disputes that, telling CNN that based on her reading of the bills, "There is no loophole currently." The language in Section 242 of the House bill limits benefits to family members who are citizens or legal residents, she said.
In addition, a widely circulated e-mail critical of the bill states that a non-discrimination clause in Section 152 would require illegal immigrants to be covered by a public health insurance plan. But the first line of that provision forbids discrimination "except as otherwise explicitly permitted by this act."
False. A new report finds the bill could require illegal immigrants to buy coverage, but it clearly restricts subsidies to U.S. citizens and legal