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Latino Leaders Riled by Role of Immigration in Health Care Debate


Rep. Joe Wilson, R-SC. President Barack Obama addresses a joint session of Congress on Sept. 9, 2009. (WDCpix)

Latino lawmakers had long ago given up on the idea that illegal immigrants would receive any sort of subsidized health insurance under a health care reform bill, even if there are strong economic, public health and moral arguments to support the idea. But what they hadn’t expected – at least not before Rep. Joe Wilson’s outburst earlier this month – was that immigrants would be so scapegoated in the health care debate that undocumented immigrants would be denied the opportunity even to purchase market-based private health insurance with their own money. That development, and other possible provisions of the Senate Finance Committee health care bill introduced by Sen. Max Baucus (D-Mont.) that may exclude even some legal immigrants from the benefits of a new health care system, threatens to undermine Latino support for Democratic lawmakers in the 2010 elections.

The Senate’s markup of the bill begins on Tuesday.


Illustration by: Matt Mahurin

“We understood that undocumented immigrants would get no taxpayer subsidy, and that there would be a verification system,” said Rep. Luis Gutierrez, (D-Ill.) in a conference call last week organized by the immigrant advocacy group America’s Voice. “We said ‘okay.’ Bitter pills were swallowed,” said Gutierrez, a member of the Congressional Hispanic Caucus. But soon after Rep. Joe Wilson (R-S.C.) publicly called President Obama a liar, said Gutierrez, “the White House started saying that illegal immigrants cannot even purchase health care on the free market health care exchange.”

After Obama in his September 9 speech said that under his health care plan, everyone “will be required to carry basic health insurance”, Press Secretary Robert Gibbs said that President Obama had never meant to allow illegal immigrants to participate in the health care exchange included as part of the proposal.

Gutierrez recalled that he was the first member of the Hispanic Congressional caucus to support Barack Obama for president, and “we galvanized the whole community to support him.” Obama had promised to bring illegal immigrants “out of the shadows” and provide “a path to legalization,” Gutierrez recalled. “That’s the president I voted for. Not one that said you can’t have health care even if you can pay for it.” Now, he added: “We’re revisiting support for health care reform.”

Latino religious leaders have similarly expressed their disappointment with Democrats who they’d previously supported and warn that they risk losing Latino support if the final bill, being worked out this week, ends up penalizing immigrants.

“Senate Democrats with the apparent support of the White House have rushed to deny undocumented immigrants the chance to use even their own money to pay for private health care,” said Rev. Luis Cortez, president of Esperanza, the largest evangelical Latino organization in the country, on the conference call last week. “We are seeing a demonizing of immigrant people,” he said, adding: “The political price is going to be high for both parties.”

“We were hopeful that the Democratic party which controls the Senate, and controls the House, and controls the executive wing was going to bring sanity to the conversation about immigration and comprehensive immigration reform,” he said. “If this is the beginning of the conversation, all we can look at as Hispanic people . . . is to look at every election and try to punish every individual regardless of their political party who denies rights to legal immigrants as well as who tries to punish those who are the poorest and most defenseless people in the country.”

In addition to the ban on illegal immigrants ability to participate in the health care exchange, immigrants’ advocates and Latino leaders worry that there’s little discussion of ending the current 5-year ban on even legal immigrants’ access to Medicaid and other health benefits. Although Sens. Rockefeller (D-W. Va.), Robert Menendez (D-N.J.), and Jeff Bingaman (D-N.M.) have all either sponsored or co-sponsored legislation to eliminate the 5-year waiting period, such proposals do not seem to be winning much support.

On the contrary, the outline of the bill released last week also suggested that there might be “a two-year waiting period for any affordability credits for legal immigrants,” said Eric Rodriguez, vice president of the National Council of La Raza, last week. Meanwhile, legal immigrants in households where some members are not documented will have only limited access to benefits. “We’ve got to change the way this debate is unfolding,” Rodriguez said.

Sonal Ambegaokar, health policy attorney at the National Immigration Law Center, said at a briefing on Monday organized by the National Immigration Forum that the markups of the bill could create a new 5-year waiting period for legal immigrants to access the health care exchange.

U.S. citizen children of illegal immigrants are also at risk of not receiving health care, although technically they’d be entitled to it. But as a practical matter, they rely on their parents to enroll them. “Last time I checked 3rd and 4th graders don’t go around buying health insurance for themselves, they get it from their parents,” said Congressman Gutierrez. “To deny the parents is to deny their children.”

There are currently about 7 million legal immigrants in the United States without health care, and 4 million U.S. citizen children of illegal immigrants, most of whom don’t have health care either.

Immigrants’ advocates are also concerned that the Baucus bill produced by the Senate Finance Committee will end up including costly and unreliable enhanced verification systems to require all participants to prove their immigration status. Those verification systems may be “fraught with errors that could eliminate eligibility for legal immigrants who should have access to tax credits,” said Jennifer Ng’andu,Deputy Director of the Health Policy Project at the National Council of La Raza, who participated in yesterday’s policy briefing.

TWI reported last year that new verification requirements for Medicaid had prevented tens of thousands of eligible U.S. citizens from enrolling in the program in just the first 18 months after it went into affect. A 2007 GAO report similarly found that states’ extra verification requirements for Medicaid eligibility led to a significant decline in Medicaid enrollment among eligible recipients who had trouble proving their immigration status. In the meantime, the states incurred much higher administrative costs. A study conducted by the House Committee on Government and Oversight Reform in 2007 found that for every $100 spent to implement the enhanced verification procedures, states could document only 14 cents in Medicaid savings.

To Frank Sharry, Executive Director of America’s Voice, that health care reform efforts would lead to scapegoating of immigrants is not surprising. “All of this started with anti-immigration groups working closely with Republicans to demagogue this issue,” he said last week. “They’ve done it for years now on virtually every social policy issue. They’ve raised the fake issue of undocumented immigrants getting access to taxpayer-subsidized programs,” he said, adding that he “would like to see Democrats standing up to these distortions.” So far, that’s not happening, he lamented. “It seems that the policy of health care reform is to dump on immigrants even if it makes bad policy because somehow it’s seen as politically expedient.”

But increasingly, immigrants’ advocates are warning that Democratic support for such efforts may not be such a politically savvy strategy after all.

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