There is some opposition in Congress to placing restrictions on legal immigrants' eligibility for health insurance benefits. Senator Bob Menendez (D-NJ), the only Hispanic in the United States Senate, has indicated strong opposition to many of the immigration restrictions in the Baucus Chairman's Mark. And Representative Luis Gutierrez (D-IL), a leader in the House on immigration matters, has warned that the Congressional Hispanic Caucus might oppose a bill that contains restrictions like the ones being speculated on for inclusion in the Baucus bill. However, it is doubtful, at best, whether that opposition will be substantial enough to eliminate or substantially mitigate the provisions.
An analysis of the summaries reveals that the immigration-related provisions in the bill would:
Immigration-Related Amendments Filed to the Chairman's Mark
The following is a brief summary of the 11 immigration-related amendments that were filed with the Committee prior to the September 19, 2009, deadline:
- Amendments to Expand Immigrant Eligibility. The following amendments to expand immigrant eligibility for health insurance coverage were filed by senators on the Committee prior to the filing deadline:
ROCKEFELLER/MENDENDEZ AMDT #C19 (COMMITTEE AMDT #199).
Senators Jay Rockefeller (D-WV) and Bob Menendez (D-NJ) filed an amendment to the Chairman's Mark that would "restore Medicaid for individuals who are lawfully present in the U.S."
More specifically, the Rockefeller/Menendez amendment would ensure "that individuals who are lawfully present in the U.S. and are otherwise eligible for Medicaid can secure coverage under Medicaid without a waiting period or other [sponsor-related] barriers."
ROCKEFELLER AMDT #C22 (COMMITTEE AMDT #202).
Senator Jay Rockefeller (D-WV) filed an amendment to expand eligibility for and increase benefits under the Children's Health Insurance Program (CHIP), a program that the Chairman's Mark would eliminate after 2013. Instead of eliminating the CHIP program in 2013, the Rockefeller Amendment would continue the program through September 30 2019.
Under the Rockefeller Amendment, legal immigrant children would be included in the expansion of eligibility and increased benefits.
MENENDEZ/BINGAMAN AMDT #C2 (COMMITTEE AMDT #301).
Senators Bob Menendez (D-NJ) and Jeff Bingaman (D-NM) filed an amendment to the Chairman's Mark that would "allow citizen and lawfully present immigrant children to get affordable health coverage while ensuring that undocumented immigrants do not benefit from the tax credit subsidy."
Consistent with eligibility for mixed-status families in the Medicaid program, the amendment would count all income and all members of a household in determining eligibility for tax credits, but would provide a tax credit subsidy only to household members who meet citizenship or legal immigrant eligibility requirements for the tax credit along with all other eligibility requirements.
The amendment would ensure that only eligible citizens and lawfully present immigrants get the benefit of a tax credit subsidy.
MENENDEZ AMDT #C15 (COMMITTEE AMDT #313).
Senator Bob Menendez (D-NJ) filed an amendment to the Chairman's Mark that would require the use of the Systematic Alien Verification for Entitlements system SAVE System) in verifying the eligibility of aliens to participate in programs under the health insurance reform bill.
The Menendez amendment would require the administering agency to protect data; improve the integrity and accuracy of the data by establishing a process by which applicants can view and correct data, if necessary; provide written responses, without delay, to individuals who make a request to amend, update, or correct records; and develop a written notice to individuals denied a benefit due to a determination of ineligibility based on a final determination under the system.
The Menendez amendment, further, would prohibit the administering agency from disclosing or sharing information provided to the exchange by individuals or the Internal Revenue Service (IRS) with other agencies, entities or individuals for any purpose that is not directly connected with the administration of the health insurance program.
- Amendments to Restrict Immigrant Eligibility. The following amendments to restrict or prohibit immigrant eligibility for health insurance coverage were filed by senators on the Committee prior to the filing deadline:
SCHUMER AMDT #C11 (COMMITTEE AMDT #270).
Senator Charles Schumer (D-NY) filed an amendment to the Chairman's Mark providing a substitute, more specific regime for verifying the lawful presence in the United States of individuals seeking benefits under the Health Care Reform bill than is contained in the Chairman's Mark.
Under the Schumer Amendment, the citizenship status of individuals claiming to be U.S. Citizens would be verified by either: (1) comparing the name, date of birth, and social security account number provided in an inquiry against such information maintained by the Commissioner of Social Security in order to confirm the validity of the information provided regarding an individual whose identity and citizenship must be confirmed; or (2) authentication of identity and citizenship through any biometric verification system administered by the Secretary of Homeland Security, the Attorney General, or the Commissioner of Social Security that is in existence, operational, and mandatory for all persons seeking employment at the time verification is required.
The Schumer Amendment would provide in the case of individuals who do not claim to be U.S. citizens but who claim to be otherwise lawfully present in the United States, the claim of lawful presence would be substantiated by authentication through any verification system administered by the Secretary of Homeland Security, the Attorney General, or the Commissioner of Social Security that is existence and operational at the time of verification.
As is the case in the Chairman's Mark, under the Schumer Amendment, individuals whose status is expected to expire in less than a year would not be permitted to obtain the tax credit. Also as is the case with the Chairman's Mark, under the Schumer Amendment whose claims of citizenship or lawful status cannot be verified with federal data would be allowed substantial opportunity to provide documentation or correct federal data related to their case that supports their contention.
Under the Schumer Amendment, within two years of enactment, the Government Accountability Office (GAO) would be required to conduct a study regarding:
(1) the rate of erroneous non-confirmations of lawful presence; (2) solutions for remedying systemic difficulties causing erroneous non-confirmations; and (3) the economic impact caused by erroneous non-confirmations and the cost of remedying any systemic difficulties causing erroneous non-confirmations.
Finally, under the Schumer Amendment, all personal information submitted to the state exchange could only be used for purposes of providing insurance coverage through the state exchange, eligibility for and determination of the amount of the health care tax credit, or other administrative functions related to the efficient operation of the state exchange. Appropriate penalties would apply to the use of fraudulent information or stolen identity information in the state exchange. Applicants for insurance coverage or for health care tax credits would be required to provide only the information that is necessary to determine eligibility for access to the exchange or tax credits. Information provided to the exchange by the applicant or by the IRS, would not be disclosed or shared with other agencies, entities or individuals for any purpose that is not directly connected with the administration of the health insurance program.
KYL AMDT #C12 (COMMITTEE AMDT # 379).
Senator Jon Kyl (R-AZ) filed an amendment to the Chairman's Mark that would, in part, eliminate the ability for legal immigrants subject to a five-year waiting period under Medicaid or CHIP to access a tax credit until the waiting period's expiration.
KYL AMDT #C14 (COMMITTEE AMDT #381).
Senator Jon Kyl (R-AZ) filed an amendment to the Chairman's Mark providing that legal immigrants must reside in the U.S. for at least five years in order to be eligible for the tax credit available through the state exchanges.
ENSIGN AMDT #C1 (COMMITTEE AMDT #400).
Senator John Ensign (R-NV) filed an amendment to the Chairman's Mark that would make legal immigrants ineligible for Health Care Affordability Tax Credits provided for in the Chairman's Mark for the first five years after their entry into the United States.
The Ensign amendment would accomplish this by designating the Health Care Affordability Tax Credits to be "federal means-tested public benefits."
ENSIGN AMDT #C2 (COMMITTEE AMDT #401).
Senator John Ensign (R-NV) filed an amendment to the Chairman's Mark that would "strengthen the eligibility verification provision in Title I, Subtitle C, and the personal responsibility compliance provision in Title I, Subtitle D."
More specifically, the Ensign amendment would add citizenship status to the list of items to be verified with Social Security Administration data for persons claiming to be citizens; provide that individuals who are trying to correct data in federal databases must not receive presumptive eligibility for tax credits; require that persons who are not initially determined to be a U.S. citizen must have their eligibility re-determined at least every five years; and; require the placement of Social Security Numbers on tax returns as a prerequisite to an individual receiving health insurance affordability tax credits; and impose fines of at least $10,000 per occurrence for each instance of a false attestation of United States citizenship.
ENSIGN AMDT #C3 (COMMITTEE AMDT #402). Senator John Ensign (R-NV) filed an amendment to the Chairman's Mark that would hold the sponsors of legal immigrants liable for ensuring that the immigrants they sponsor have health insurance. Under the Ensign amendment, in the event that a sponsored immigrant does not obtain health insurance coverage, the immigrant's sponsor would be "liable for all costs incurred by the American taxpayers should a sponsored alien receive any taxpayer-funded health care."
Under the Ensign amendment, in order to ensure compliance, a sponsor would be required to report on his/her federal income tax return the months for which he/she maintains the required minimum health coverage for him/herself, dependants and all sponsored immigrants. If neither the sponsor nor the sponsored immigrant do not maintain the requisite health insurance for the sponsored immigrant, then the sponsor would be required to pay the greater of: (1) the excise tax specified in the chairman‘s mark for an individual who does not maintain insurance (based on the income of the immigrant); or (2) any amount provided to such immigrant in the form of a tax credit pursuant to this bill. Furthermore, in the event a sponsor fails to ensure that one of his/her sponsored immigrants maintains adequate health insurance during the period specified in Section 421 of PRWORA, such sponsor will not be allowed to sponsor any immigrants in the future.
GRASSLEY AMDT #F6 (COMMITTEE AMDT #488). Senate Finance Committee Ranking Republican Charles Grassley (R-IA) filed an amendment to the Chairman's Mark that would apply a five-year waiting period for legal aliens before they could be eligible for the Health Care Affordability Tax Credits found in the Chairman's Mark.
The Grassley Amendment uses the restriction on immigrants' eligibility for the Health Care Affordability Tax Credits as an offset to pay for a provision providing that qualified prescription drug plan subsidies are excludable from the plan sponsor's gross income for the purposes of income tax and alternative minimum tax.
