Illegal Aliens & the Senate Healthcare Bill — Better Than the House’s, But Still Filled With Loopholes

This is my analysis of provisions pertaining to illegal immigrants as contained in Sen. Reid’s health reform bill, H.R. 3590.

The Senate health reform bill is better than the House-passed bill, in terms of verification of immigrant or citizenship status. But the Senate bill contains a number of serious loopholes by which illegal aliens can and will obtain taxpayer-funded health coverage. This will provide a net bonus to at least a portion of illegal aliens and may well serve as yet another incentive to break U.S. immigration laws.

Section 1411 provides for eligibility verification, including on the basis of citizenship or immigration status. And the verification applies more broadly than does its more vague counterpart in the House bill, H.R. 3962. The loophole-ridden House legislation requires a form of verification only for the premium subsidy. The Senate bill requires verification for entry into the “exchange” (a government clearinghouse for regulating the insurance mandates, subsidies, and policies for individuals and employers), premium tax credits, reduced cost-sharing, and exemptions from the individual mandate requiring most people in the U.S. to carry health insurance.

However, the Senate bill contains loopholes that almost ensure illegal aliens will obtain health benefits at taxpayer expense, in the hundreds of billions of dollars.

Main Senate bill immigration problems:

Attestation: Those seeking to enroll in the exchange or for a premium subsidy (or cost-sharing reduction or exemption) attest to their eligibility. While a proffered SSN or “identifying information” of immigration status is checked, no more reliable identifier (e.g., biometrics, REAL ID-quality documentation, government-issued photo ID) is required. Therefore, someone giving a valid name, date of birth, and SSN will be cleared as “eligible.” This opens the door to identity theft and fraud.
Immigration status “identifying information”: The Secretaries of HHS and DHS determine what identifying information relating to one’s immigration status is “appropriate.” Thus, Congress delegates this important decision to unelected bureaucrats, who are more likely to be influenced by secret inputs by ethnic advocacy groups (La Raza, ACORN, MALDEF).
Verification process: The HHS Secretary, consulting with other cabinet departments and agencies, verifies proffered information using “an on-line system or otherwise for the electronic submission of, and response to, the information.” The SAVE system, which already exists and has been in place for over a decade, is not specified. Therefore, an inferior verification system may well be established. Further, HHS is expressly given “flexibility” to modify the verification process so as to “reduce” the “burdens on the applicant.” Finally, the citizenship/immigration verification when inconsistencies are found are to be determined/reconciled using the less effective means used for Medicaid, as modified by the SCHIP reauthorization, which is less reliable and less robust than the previous verification requirement involving more solid ID.

There is high likelihood that the Senate health bill will result in illegal aliens receiving taxpayer-funded health care. This will come about by less reliable “verification” processes, identity theft and identity fraud, reduction of the level of vigilance in verification processes over time, as well as indirectly. Illegals will benefit from tax credits to smaller employers who offer taxpayer-subsidized health coverage to their workers, from the fungibility of money in mixed-status households that receive premium subsidies or subsidized employer health benefits. The cost of such illegal alien benefits is likely to reach the tens or even hundreds of billions of dollars. The fact that the Senate bill’s supposed barriers to illegal alien participation in the big-ticket health programs suffer from the several weaknesses identified above is likely not to deter much illegal immigration; over time, as loopholes widen and the ability to benefit widens, the health care policy could serve as one of the enticements for would-be illegal aliens.

Bottom line, the Senate bill is relatively better, in immigration terms, than the House-passed bill. However, it still is likely to enable fraud and abuse, cost taxpayers hundreds of billions, overall make foreign lawbreakers better off than they otherwise would be, and contribute to the power of the magnet that attracts aliens to break immigration laws.

DR. JAMES EDWARDS is a consultant with NumbersUSA’s Capitol Hill Team. In addition to his long experience with immigration legislation, he has deep experience with healthcare issues in Congress