Last week, Democratic leaders in the U.S. House of Representatives unveiled their health care reform legislation entitled, “America’s Affordable Health Care Act of 2009.” (Bill Text). Despite the language in section 246 of the bill that states: “nothing . . . shall allow Federal payments [for] individuals who are not lawfully present in the United States,” the bill actually raises more questions than it resolves with respect to whether the bill will burden American taxpayers by giving health care benefits to legal and illegal aliens.
The draft House bill–consisting of 1,018 pages–was introduced by Rep. John Dingell (D-MI) and cosponsored by the chairmen of the three House committees of jurisdiction: Rep. Charlie Rangel (D-NY), Chairman of the Ways & Means Committee; Rep. Henry Waxman (D-CA), Chairmen of the Energy & Commerce Committee; and Rep. George Miller (D-CA), Chairman of the Education & Labor Committee.
Section 202 of this bill creates a Health Insurance Exchange (exchange) and states that “all individuals are eligible to obtain coverage” through the exchange. The House Education & Labor Committee has produced a summary of the bill and explains that the exchange will allow individuals and employers to “comparison shop for coverage” and that the bill creates “new affordability credits . . . for people purchasing [health coverage] through the exchange.” (Education & Labor Summary).
Under Section 242, all legal aliens will qualify for the affordability credit. Subsection (d) states that the affordability credits “shall not be treated [as] a benefit provided under section 403” of the Welfare Reform Act of 1996. Under Welfare Reform, legal aliens are generally required to wait five years before becoming eligible for welfare or other taxpayer funded benefits. The House health reform bill eliminates that 5-year waiting period for legal aliens as applied to taxpayer financed health insurance subsidies, such as the affordability credit. Accordingly, legal aliens will become immediately eligible for this government handout–a handout that would be paid for by the American taxpayers.
Given the bill’s language, illegal aliens are also likely to qualify for the affordability credit. This is true because there are no provisions that would prevent an illegal alien from participating in the exchange or from receiving the credit. Likewise, there are no requirements that a government agency verify eligibility, whether through the SAVE system or otherwise. (FAIR’s explanation of the SAVE System). Accordingly, without these important safeguards, illegal aliens would probably receive this subsidy. The bill does limit eligibility to individuals who are “lawfully present in a State in the United States,” but that language would be ineffective to prevent handouts to illegal aliens. (Sec. 242(a)(1)). Under U.S. immigration law, someone’s status as an illegal alien is not determined by lawful presence in a State. As a result, this language will have no effect in preventing illegal aliens from receiving the credit.
Critics suggest that if the intent of the bill is to preclude illegal aliens from receiving this subsidy, the current language is woefully inadequate and would have to be dramatically revised. For example, the bill could limit eligibility for the credit only to a “qualified alien” as defined by the Welfare Reform Act, which would preclude illegal aliens from receiving any benefit. In addition, including a provision that requires eligibility verification, with the SAVE system, for every applicant for the credit would likewise prevent illegal aliens from receiving the credit.
At the same time as Congress is considering burdening taxpayers with the cost of health care for legal aliens, Massachusetts appears to be retreating from that idea. Massachusetts is currently the only state to offer so-called “universal health coverage.” The Bay State is currently facing a budget crisis brought on by a decline in tax revenue and rising demand for state-financed services. In response, state legislators have recently submitted a budget to eliminate taxpayer subsidized health coverage for approximately 30,000 legal immigrants under the “Commonwealth Care” program. (Boston Globe, July 12, 2009; New York Times, July 14, 2009; Boston Globe, July 15, 2009; and SouthCoastToday.com, July 16, 2009).