Fact is, illegal immigrants are in 'health care purgatory'
September 11, 2009
So Joe Wilson shouts crudely, "You Lie," at the president from the House floor. What's the truth about illegal immigrants and health care?
Karen E. Crummy of the Denver Post, takes a look at the language of the House bill, and determines that while illegal immigrants are not exempt from the requirements to buy insurances and not prohibited from enrolling in the "Health Insurance Exchange," which offers access to private plans and a public option (should it ever come to pass) they must be in the country lawfully to receive subsidies based on income. That's according to research by the the Congressional Research Service, a nonpartisan arm of Congress.
"While there are no spelled-out citizenship verification procedures, implementing proper mechanisms would fall to the health choices commissioner, a presidential appointee position, created by the legislation, who would oversee a new regulatory body, according to congressional services. There are citizenship checks already in place for federal programs such as Medicaid, which could be used for this purpose.
Additionally, Leighton Ku, a health policy analyst and professor at George Washington University, said that because the bill ties subsidies to substantiated income, there already exists a good method to weed out fraud through tax returns. Those require Social Security numbers, which illegal immigrants are barred from obtaining.
While some people - both noncitizens and citizens - may try to use false Social Security numbers, the numbers are likely small, Ku said.
Ku points out that while there is always some fraud, social security numbers are a "well-established way to determine whether someone is a citizen in this country."
Southern Methodist University Law School Prof Nathan Cortez, in his The Health Care Blog, also analyzes the issue, writing that both the House and Senate bills state "in pretty clear language" that they don't cover illegal immigrants. The bills would, however, allow illegals to purchase coverage without subsidy. And let's hope that even Joe Wilson wouldn't have a quarrel with that.
"This controversy should remind us that immigrants remain in a sort of health care purgatory, caught in our two most dysfunctional systems - immigration and health care. In the mid-1990s, Congress severely limited immigrant access to programs like Medicaid as part of welfare reform, making it difficult for even lawful immigrants to enroll. In fact, even lawful immigrants aren't eligible for Medicaid for five years after entering the United States - and various peculiarities of immigration law often push this waiting period to ten years. At the same time, immigrants do receive indirect federal funding for health care through the Emergency Medical Treatment and Active Labor Act(EMTALA), which requires hospitals with emergency departments to screen and at least stabilize patients presenting with emergent conditions. Thus, hospitals must provide emergency care regardless of the patient's immigration status.
Unfortunately, most immigrants are ineligible for means-tested public insurance programs like Medicaid. This regulatory framework has led to "medical repatriation," in which hospitals effectively deport immigrant patients to unload expensive long-term care burdens.
-- Rita Hibbard
Environment | April 2014
Energizing our world with wood sounds so natural. And it has quickly become a multibillion-dollar industry as governments including British Columbia and the European Union turn to biomass to replace dirty old coal. Yet what we found when we dug into the coal-vs.-wood debate will surprise you.
Public Health | April 2014
We update our 2013 series on Washington’s estimated fish consumption rate with news of a private meeting where Gov. Jay Inslee and his advisers wrestled with how much to protect business versus consumers when it comes to water pollution in the fish we eat.
Consumer Safety | April 2014
Manufacturers put a warning sticker on every ATV sold: The vehicles aren't meant for roads. But a push to allow just that is rolling out across the country. Washington and three other states passed new laws in 2013, among 22 states to allow or expand ATV access to roads since 2004.
Wealth & Poverty | December 2013
It's the unexpected catch in catch-share programs: A federal program that was supposed to help preserve and enhance the fishing economy in Kake, Alaska, has instead helped cause a severe decline. Meanwhile, 50 miles southeast, the town of Petersburg is booming.
The third part in our trilogy of fish stories examines the consequences catch-share policy where it was born, even as the model has been established in 14 other U.S. fisheries, encompassing dozens of species ranging from New England scallops to Pacific sole.
Foster Care | November 2013
State law now allows more kids to stay in foster care for an extra three years — until age 21. But many either refuse the help, or fail to qualify for it.
An investigation by KUOW in collaboration with InvestigateWest looks at why this transition to adulthood is trickier than expected – for foster kids, and for the state.
Public Health | September 2013
Of the roughly 50,000 kids who will attend Seattle schools this fall, nearly 2,000 will hit the books in classrooms within 500 feet of Interstate 5, InvestigateWest has found. This despite a body of evidence dating back decades that highway air pollution can cause lifelong respiratory problems and asthma attacks and boost school absenteeism.
From Seattle to Spokane, what can be done to make sure schools are healthy places for kids?
Photo: John Marshall JHS, 1963. SPSA 108-97.
Public Health | July 2013
Memory loss is one of the symptoms of dementia. So is wandering. Over the last five years, at least 10 people in Washington state have died after wandering away from where they live. It’s a problem that communities will have to confront as the population ages. But not all police departments are prepared for these kinds of incidents.
Wealth & Poverty | June 2013
Six nonprofit groups arose on the Bering Sea shore, and they have invested mightily in ships, real estate and processing plants. Over two decades, the groups amassed a combined net worth of $785 million," write Lee van der Voo and The New York Times' Kirk Johnson.
But the results on the ground, in rural community and economic development, have been deeply uneven, and nonexistent for many people who still gaze out to the blinking lights of the factory ships and wonder what happened. Photo Credit: Jim Wilson/The New York Times