After Representative Joe Wilson's (R-SC) outburst last night, it's clear that there is a distinct concern amongst conservatives as to whether H.R.3200 - the health care bill that everyone has been roaring about - will effectively subsidize health care for illegal immigrants. The Right has long suspected that Democrats are willing to buy Hispanic votes at any cost; Rep. Wilson's outburst is merely a publicly displayed manifestation of that suspicion. What's the truth though? Will H.R.3200 provide free health care to non-citizens/illegal immigrants? Once again, I've decided the easiest way to answer this question is by reviewing the latest Congressional Research Service report, titled "Treatment of Noncitizens in H.R.3200". The report is encrypted, so I can't load it up to the site right now; I can email the report to anyone who thinks I might be misrepresenting it's content, but otherwise you'll need to trust me.
Coverage Requirements
First of all, H.R.3200 would require that all legal permanent residents, non immigrants, and unauthorized aliens (who meet certain requirements pertaining to amount of time spent in the country) obtain health insurance coverage. Well, actually H.R.3200 would only amend the Internal Revenue Code such that an additional tax would be levied upon any of the individuals listed above who do not obtain health insurance coverage; men in black suits will not be appearing at your doorstep to compel you to sign a health insurance policy. Clearly, unauthorized individuals could obviate this provision by simply not filing taxes; however, speaking for myself, I probably wouldn't file my taxes either if the government was unaware of my existence.
The Health Exchange
H.R.3200 would establish - effective 2013 - a health insurance exchange; the exchange isn't in and of itself an insurance provider, it is merely a uniform way of presenting the various private insurance options alongside the public option. H.R.3200 does not address whether or not an individual must be a legal US citizen in order to participate in the exchange, in theory making it completely possible that an illegal immigrant could participate. A bit of editorial here though: the alternative is emergency room visits that drive up the cost for everyone. Also, please read the "Credits" section below before you jump to conclusions.
Health Care Credits
Enough with the euphemisms, the portion of H.R.3200 that refers to "credits" is talking about a government subsidy of health insurance premiums for lower income individuals. For the purposes of this article, it's irrelevant how the government will calculate the amount of subsidy that an individual is eligible for. What is relevant though, is that in order to qualify for a health insurance subsidy of any sort, an individual must be lawfully present in the United States. There are a handful of exceptions, although they may have been added to the bill in an attempt to trick Republicans into opposing their inclusion. The following groups of people MAY receive subsidies, even if they are not lawfully present in the US: trafficking victims, crime victims, fiancees of US citizens, and those who have applied for US citizenship but whose application has been stalled in the bureaucracy for 3 years or more.
The CRS report - which was prepared by Alison Siskin (immigration policy expert) and Erika K. Lunder (legislative attorney) - makes an intriguing point that is nearly identical to my first impression of the immigration related provisions of H.R.3200. Specifically, the bill would require certain resident aliens to secure health care coverage, but would prohibit them from receiving credits towards it's purchase - even if they qualified from an income standpoint!. Thus, I don't think it's too much of a stretch to state that, in many instances, it will be foreigners/illegals/noncitizens (whatever your preference) who will be subsidizing health insurance credits for others!
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Thursday, September 10, 2009
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