MicEvHill.Com - Pathway Could Soon Be Cleared For Vote On Menendez Medcaid State Option Amendment to Health Care Reform Bill

Pathway Could Soon Be Cleared for Consideration of Menendez Medicaid State Option
Amendment to Health Care Bill Reform

Notwithstanding the chaos that has ensued in the Senate during the last several days over the apparent demise of various "public option" health care reform compromises, the pathway could soon be cleared for Senate consideration of an amendment to its health care reform bill that would give states the option of waiving the requirement under current law that legal immigrants be in the United States for at least five years before accessing the Medicaid program. The pathway for consideration of the Medicaid State Option Amendment could well be cleared this evening after the Senate votes on four controversial amendments and motions, including two proposals relating to drug reimportation. The Medicaid State Option amendment was drafted by Senator Bob Menendez (D-NJ), who is the only Latino in the United States Senate. He filed it more than two weeks ago, and it has been waiting in a cue of more than 400 amendments that have been filed to the Senate's landmark health care reform bill. It is one of at least five immigration-related floor amendments to the Senate's health care reform bill that have emerged in recent weeks. Three of the other four amendments are decidedly less generous to immigrants. Senator Menendez is joined in offering his Medicaid State Option amendment by Senators Jay Rockefeller (D-WV), Jeff Bingaman (D-NM), and Dick Durbin (D-IL), and his amendment is strongly supported by the pro-immigrant advocacy community.

At least three of the other four immigration-related amendments that have emerged over the last several days are likely to be opposed by the pro-immigrant advocacy community. Two of them were drafted by Senator John Ensign (R-NV). The first would require a social security number for eligibility for exchange participation, premium tax credits and reduced cost-sharing, and individual responsibility exemptions. And the second would provide lower income American citizens with the right to opt out of Medicaid and receive the refundable tax credit in order to buy private insurance, in the same way that section 1401 of the Reid Substitute to the Senate health care reform bill would give legal immigrants access to such credit to buy private insurance. The third of the amendments that are likely to be opposed by the pro-immigrant advocacy community was drafted by Senate Judiciary Committee Ranking Republican Jeff Sessions (R-AL). The Sessions amendment had not been filed at the time of this writing. However, according to sources who have seen its text, it would enhance the citizenship and immigration status verification system that is included in the Reid Substitute, take further steps to ensure that illegal immigrants do not use their own funds to purchase health insurance on the health insurance exchanges that the biill would create, and subject legal immigrants to a five-year-long waiting period before they can access affordability tax credits that the bill would establish. The Menendez amendment could be voted on as a separate, stand-alone amendment as soon as today or tomorrow. However, Senator Menendez also could hold the amendment back and attempt to get it put into a catch-all "Manager's Amendment" being assembled by Senate Majority Leader Harry Reid (D-NV) that would consist of many other changes to the health care reform bill. Under either scenario, it is likely that 60 affirmative votes will be necessary in order for the Senate to agree to the Menendez amendment.

The health care reform bill that the Senate is considering contains a number of provisions relating to immigrants' access to health insurance. The measure's immigration-related provisions are substantially similar to those that were contained in the Senate Finance Committee's health care reform bill. However, there are some changes around the edges.

More than 400 amendments to the health care reform bill had been filed by the close of business on Monday, December 14. The Menendez, Ensign, and Sessions amendments are the only ones so far that have contained provisions that would have significant immigration- or refugee-related consequences.

In the meantime, Senator Joe Lieberman (I-CT) yesterday pulled the rug from beneath a public option "compromise" that Senate Democrats had been counting on to provide a pathway for Senate passage of its health care reform bill. During a Sunday, December 13, 2009, appearance on the CBS's Face the Nation, Senator Lieberman announced that he would support a Republican filibuster of the Senate health care reform bill if it contained a compromise proposal that has been advanced by the "Gang of Ten", a group of ten moderate and liberal Senate Democrats. That compromise, which would have permitted Americans between the ages of 55 and 64 to buy into Medicare, had been advanced by the Gang of Ten as a substitute for enacting a public health insurance plan into law. During an emotional meeting of the Senate Democratic Caucus Monday evening, the Connecticut senator repeated his support for a filibuster should the Senate include the Medicare Buy-In compromise in its health care reform bill. Following the Caucus meeting, numerous Democratic senators declared the Medicare Buy-In compromise plan all but dead. Senators now will await word from the Congressional Budget Office (CBO) on whether other aspects of the Gang of Ten's proposal would reduce the budget deficit and curb health care spending before deciding how to proceed toward final passage of the measure.

Senate Democrats are under great pressure to pass the Senate heallth care reform bill before the end of the year. In order to do so, Senate Majority Leader Harry Reid (D-NV) will have to unravel a parliamentary quagmire that the Senate has found itself in by securing the votes of at least 60 senators on each of three separate cloture votes to shutdown debate on various amendments that are pending before the Senate. Without Republican cooperation, the process of invoking cloture and exhausting all post-cloture debate on the three pending questions could take as many as seven-to-nine legislative days. This means that in order for the Senate to pass its health care reform bill before Christmas, the Majority Leader will have to file the first of the three cloture petitions sometime this week. And he cannot do that until he has finalized the text of the measure and until he is assured that at least 60 senators will support that text. Senate Democrats, including Independent Senator Lieberman, are scheduled to meet with President Obama this afternoon to discuss how to come to a conclusion on the Senate's consideration of health care reform legislation.

The pressure that Senate Democrats are under to begin the process of completing action on its health care reform bill also increases the pressure on Senator Menendez to quickly win passage of his Medcaid State Option amendment. Once a cloture petition is filed, it is likely that the pathway for considering all pending amendments will become much more difficult.