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Jon Walker made a list this week of 35 ways to improve the Senate health care bill. This was #30:
Make all legal immigrants eligible for all public health care programs right away, instead of creating a five year wait.
Under current law, legal immigrants are subject to a 5-year waiting period before accessing programs like Medicaid. The Senate bill did not alter this feature of our health care system. But Robert Menendez has exacted a concession from Harry Reid on the issue:
During the Senate negotiations, Robert Menendez—the only Hispanic lawmaker in the Senate—pushed for an amendment that would eliminate the five-year waiting period that is imposed on legal, newly naturalized immigrants before they are allowed to be eligible for Medicaid benefits. The Medicaid waiting period was created in 1996 during the conservative anti-immigration crackdown, and immigration advocates have long fought to remove the provision, arguing that tax-paying legal immigrants shouldn’t be denied basic government services. According to Menendez, eliminating the waiting period would potentially make about 600,000 adults newly eligible for Medicaid. While the provision was not included in Reid’s manager’s amendment to the Senate bill, Menendez “got a commitment from the Majority Leader to include it in conference,” Menendez spokesperson Afshin Mohamadi told TNR today.
FDL News has confirmed this with Menendez’ spokesman.
Rachel Larris estimates that this would allow up to 600,000 legal immigrants to become eligible for Medicaid right away, and “Evaluation of the amendment by the Congressional Budget Office (CBO) found that there is no cost associated with the amendment.” I guess the savings of uncompensated care offsets the cost of Medicaid.
There is still a fight that will be had between the House and the Senate on the subject of naturalized – and undocumented – immigrants purchasing health care on the exchange. Right now undocumented immigrants are barred from the exchanges entirely, even if they want to purchase insurance with their own money. And the law is unclear on whether lifting the waiting period on naturalized immigrants for Medicaid applies to the exchanges as well. Members of the Congressional Hispanic Caucus have threatened to vote against the bill for this reason. My assumption is that the CHC will get a “promise” to move forward on comprehensive immigration reform in 2010, which would get around the issue of barring 11-12 million people currently in this country from the exchanges, at least over time. The legal immigrant/exchange issue still has to be addressed.
There are still 34 more items on Jon Walker’s list, but at least we’re making progress on one of them, which happened to be one of the least defensible of the bunch.
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If we are going to give up the public option, we should get some turkey for it. what turkey?
Yes, the exchanges and the subsidies should start in 2013. This is a Depression. Forget the impact on the CBO score, or make the hike of the medicare tax on 200k earners 1.2% or 1.5%.
what else?
Americans can still insist on improvements to the Senate bill and that has to come from House conferees who point out that they gave up the public option to give a healthy stroke job to Lieberman and Nelson.
If we can’t have a public option, we should require insurance companies to spend 90 percent of premium on medical care, pre-existing condition ban for everyone not just kids starting in 2010, the House 2x rating for older insured and, we must have a permanent COBRA extension for workers who lose their jobs.
Particularly important is for the HOUSE to stand up for COBRA extension for the unemployed, which is in the House bill, Section 113. We need to help the unemployed keep their insurance until the exchanges start, without forcing them into expensive high-risk pools.
Section 113 of the House bill permits the unemployed, many of whom can’t get individual coverage because of pre-existing conditions, to buy into their old group insurance until the insurance exchanges start in 2013.
And one other thing. These are the insurance companies we are fighting, not folks who make cars or milk.
These are folks who call the service they provide — that is the medical care of their clients — they call it a loss; specifically the medical loss ratio.
These are folks who profit if you die. Who make more money if you dont get care.
COBRA’s not going anywhere. In fact, Obama just signed, in the defense bill, an extension of the COBRA subsidy from the stimulus for another six months.
Congress does some strange things. Not only is there an unreasonable waiting period for legal immigrants to become eligible for Medicaid, there is a two year waiting period for a lifelong citizen who is a recipient of Disability Social Security to get on Medicare. How does that make any sense. Obviously if you’re disabled and can’t work or support yourself, you need healthcare. Who do they think will provide it?
Just another example of American “exceptionalism.” Why should some “foreigner” be entitled to the blessings and bounty of the greatest country the world has ever seen without paying their dues (being treated like a serf.)
It is incredible to me that any thinking person would want to deny access to health care to immigrants, legal or not.
To deny people the opportunity to buy in to insurance plans is absurd. Stunningly short-sighted.
But but but immigrants are not humans. /s
2/3 – like women used to be.
I think that was slaves, and I think the ratio was 3/5, but don’t hold me to that. I’m just inside for a moment to load an audiobook disc on my ipod.
Unless you’re talking about Islam, where I think the woman being 2/3 of a man for inheritance and witness in court. But don’t hold me to that either.
I think it was pathetic that naturalized citizens would have to wait 5 years before eligibility. This is after they had already waited 5+ years to get through the process of naturalization. They have been legal residents for over 10 years, paid taxes, lived in the Community…and we would still deny them healthcare? Who was behind this clause, I wonder? Shouldn’t the naturalized citizens, and those waiting, in that state learn who was selling them down the river?
I don’t know how many undocumented immigrants would want to “buy-in” or would qualify. I thought the “exchanges” pretty much excluded the self-employed…and the prices for any insurance would likely be prohibitive under this bill. They’ll likely continue to use the emergency rooms, free clinics, and if (they are Mexican) and there is something else more serious they’ll just cross the border and get treatment in Mexico.
In fact, I think that many Americans might find that “Health tourism” is their option of choice. They may just choose to “eat” the cost, and get their chronic knee surgery or hip replacement abroad, especially if to afford it requires a “Cadillac Plan” and that plan is taxed heavily. Many Americans are already doing this for major surgeries, and dental work, amongst other things that require a long lay-up with nursing care.
thanks, DD.
But I am not talking about a COBRA subsidy; rather, a COBRA extension so it doesnt end in 18 months.
It is in the HOUSE bill.
I suspect that the COBRA extension would have easily passed long ago if it were not embedded within the bill. In a sense it was held hostage as a bargaining chip. Remember, this was a renewal of an already passed extension, which expired. It made it through even though the Democrats were weaker. It was packaged as part of the bill to lure over some Republicans who would have a hard time, supposedly, justifying this before their constituents. It didn’t work.
again, this is making COBRA extend until the exchanges start.
It is not the subsidy.