MicEvHill.Com - Prospects Fade for Consideration of Standalone Medicaid State Option Amendment to Senate Health Care Reform Bill

Standalone Consideration of Menendez Medcaid State Option Amendment to Senate Helath Care Reform Bill Looking Increasingly Unlikely As Senate Democratic Leadership Prepares to File Cloture on Manager's Amendment to Measure

The possibility of votes on immigration-related floor amendments to the Senate health care reform bill is looking increasingly less likely this morning as Senate Majoriity Leader Harry Reid (D-NV) prepares to to take the initial steps to shutdown debate on the Senate's health care reform bill. The Majority could unveil a "Manager's Amendment" to the Senate health care reform bill as soon as today and then file a cloture petition to shutoff debate on the amendment. Should the Majority Leader unveil and then take action to shutdown debate on his "Manager's Amendment", it likely would constitute a fatal blow to the prospects of Senate consideration of a standalone 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. Notwithstanding the poor prospects for consideration of a standalone amendment to ease the five-year bar on immigrant participation in the Medicaid program, however, it is possible that the Majority Leader will include the Medicaid State Option proposal within the Manager's Amendment, obviating the need for a vote on the standalone version of the proposal.

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 Tuesday, December 15. 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, Senate Majority Leader Reid moved closer yesterday to assembling the 60 votes he will need to shut down debate on the health care reform bill. Senator Joe Lieberman (I-CT), who previously had 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, indicated yesterday that he likely would support the health care reform bill now that Senate Democrats have abandoned both a public health insurance option and a Medicare Buy-In that would permit Americans between the ages of 55 and 64 to buy into Medicare. At the time of this writing, it appears that the lone holdout among the 60 senators who caucus with the Democratic party is Senator Ben Nelson (D-NE), who is concerned about the treatment of abortion in the Senate health care reform bill.

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.