Newsweek Misses the Mark on Health Care for Illegal Aliens

From FAIR's Government Relations team,

An August 29 article written by Newsweek's Sharon Begley claims that one of the "five biggest lies in the health care debate" is that "illegal immigrants will get free health insurance" under the health care reform proposal supported by President Obama. While FAIR hasn't claimed that the House health care bill (H.R. 3200) expressly makes illegal aliens eligible for "free health insurance," we were the first organization to point out that the legislation contains giant loopholes that will allow illegal aliens to access taxpayer-subsidized health care and affordability credits.

Rather than address the substance of FAIR's concerns, namely the loopholes, Ms. Begley's article circumvents any discussion of these concerns to characterize FAIR's concerns as "lies." But Ms. Begley's own conclusions regarding this issue can themselves be easily debunked:

Begley claim #1: "The house bill doesn't give anyone free health care (though under a 1986 law illegals who can't pay do get free emergency care now, courtesy of all us premium paying customers or of hospitals that have to eat the cost). Will they be eligible for subsidies to buy health insurance? The house bill says that 'individuals who are not lawfully present in the United States' will not be allowed to receive subsidies."

The "subsidies" Begley is referring to are the so-called affordability credits created by H.R. 3200. These credits would be available to individuals to help them pay for private health insurance. She quotes part of Section 246 of the bill, which makes illegal aliens ineligible for these affordability credits. However, as FAIR has consistently stated, H.R. 3200 lacks any meaningful verification procedure to ensure that illegal aliens will in fact be prevented from receiving these subsidies. Simply put, the statutory bar of Section 246, which Ms. Begley relies on to reach her conclusion, is not nearly enough to prevent anyone who is ineligible, including illegal aliens, from accessing the affordability credits. President Obama has promised the American people that his bill will not allow illegal aliens to access taxpayer funded health benefits. FAIR has consistently stated that his bill must contain a meaningful form of eligibility verification for the President to keep that promise to the American people.

Begley claim #2: "The claim that taxpayers will wind up subsidizing health insurance for illegal immigrants has its origins in the defeat of an amendment, offered in July by Republican Rep. Dean Heller of Nevada, to require those enrolling in a public plan or seeking subsidies to purchase private insurance to have their citizenship verified...Can we say that none of the estimated 11.9 million illegal immigrants will ever wrangle insurance subsidies through identity fraud, pretending to be a citizen?"

Begley mentioned the heavily-debated "public plan." The House bill creates a "Health Insurance Exchange" where individuals could go to shop for health insurance. One of the choices that will be offered at this exchange will be the heavily or entirely taxpayer-subsidized public plan. As FAIR has pointed out, the House bill contains no language whatsoever to bar illegal aliens from enrolling in this plan - not even a statutory bar, like Section 246 (which applies solely to affordability credits). The Heller Amendment Ms. Begley mentions was meant to close both the affordability credit loophole and the loophole that will allow illegal aliens to enroll in the public plan. Heller's amendment would have required that both applicants for the credits and individuals who are attempting to enroll in the public plan have their immigration status verified through the Systematic Alien Verification for Entitlements (SAVE) system. This amendment was defeated on a party-line vote.

Ms. Begley implies that, in order to receive taxpayer-subsidized health insurance under the House health care bill, an illegal alien would have to commit "identity fraud." This is simply untrue. H.R. 3200 creates nothing more than an "honor system" to prevent taxpayer-provided coverage for illegal aliens. The only thing that will prevent an illegal alien from receiving benefits under the House bill is to have the illegal alien decide to forego applying for those benefits. An illegal alien wishing to take advantage of taxpayer-subsidized health insurance won't need to commit identity fraud because without a verification mechanism, an illegal alien could freely enroll in the public plan under their own name. This obviates the need to steal another person's identity to access the public plan or credits.

Furthermore, a report released last week by the nonpartisan research arm of the United States Congress - the Congressional Research Service (CRS) - has validated FAIR's analysis of the House health care bill. With respect to whether illegal aliens will be able to access the Health Care Exchange - and, as an extension, the public plan - CRS stated: "H.R. 3200 does not contain any restrictions on noncitizens -whether legally or illegally present, or in the United States temporarily or permanently - participating in the Exchange." The CRS report also noted that the bill does not contain any mechanism to verify the immigration status of applicants for the affordability credits. According to CRS, a federal bureaucrat created under the bill (called the Health Choices Commissioner) might implement a verification procedure to ensure that illegal aliens would not be able to access the affordability credits. However, nothing in the bill as it is written now would require the Commissioner to do this; accordingly, American taxpayers would be much better served if Congress were to adopt a statutory verification requirement.

Begley claim #3: "You can't prove a negative, but experts say that Medicare - the closest thing to the proposals in the House bill - has no such problem."

Ms. Begley draws comparisons to Medicare in an attempt to make a further point. She cites "experts" who say Medicare is "the closest thing to the proposals in the House bill" but then does not support this comparison. Then, again without any support, Begley suggests that Medicare has no problems with illegal alien coverage. This leaves her readers to conclude that verification is unnecessary as part of the new programs created by H.R. 3200 because Begley suggests it is unnecessary for Medicare. We respectfully have to take issue with both her analogy and her conclusion.

Begley fails to identify the experts she cites or to explain their reasoning for selecting Medicare as the "closest" program to compare to those created by the House bill. It is hard to know why Begley's experts selected Medicare, but Medicaid would have been the better program to use to compare H.R. 3200's affordability credits to for at least four reasons. First, H.R. 3200 creates a series of "State-based" health insurance exchanges at which people can enroll in a health insurance program. Similarly, Medicaid is also stated-based; Medicare is not. Second, the affordability credits, like Medicaid but unlike Medicare, are means-tested - beneficiaries have to have income below a certain threshold to qualify for the benefits. Third, the affordability credits and the public option, like Medicaid, are available to all eligible individuals regardless of age, whereas Medicare is a program for America's seniors. Fourth, Medicare is a social insurance program with earned eligibility - Medicare beneficiaries are required to have first contributed to the program, through payroll taxes, in order to later qualify for the program's benefits. By contrast, Medicaid and the affordability credits under H.R. 3200 do not require that someone first "pay into the system" years in advance to earn subsequent eligibility.

For these reasons, Medicaid is a far more analogous benefits program to those created under H.R. 3200 than Medicare or any other current federal program. Medicaid has had, since 1986, a verification requirement in place to ensure that ineligible persons do not obtain benefits. The verification system used to determine eligibility under Medicaid and prevent illegal aliens from getting these benefits is the Systematic Alien Verification for Entitlements (SAVE) system. The Heller Amendment, which Begley writes about, would have mandated the use of the SAVE system to determine eligibility in much the same way it is required to be used for Medicaid. Accordingly, this belies Ms. Begley's conclusion that the House health care bill needs no verification mechanism to ensure eligibility. When faced with a more true comparison, using Medicaid, one can only conclude that not only is an eligibility verification mandate advisable to ensure proper administration of benefits, IT IS ESSENTIAL.