Latest Senate Health Bill's Immigration Smoke and Mirrors

By James R. Edwards, Jr. on November 22, 2009

Senate Majority Leader Harry Reid's "Patient Protection and Affordable Care Act" gives the appearance of going further to bar illegal aliens from taxpayer-funded health benefits than the House-passed legislation or other Senate bills. But a closer read exposes loopholes, flaws, and the very tools for quickly undoing whatever merits the Reid measure contains.

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The immigration-related provision, Section 1411, shows the elements that may cause public cynicism. Most Americans don't think people who broke our laws to get here, break our laws by remaining here, and who routinely break other U.S. laws beyond immigration statutes (e.g., identity theft and fraud, tax cheating, illicit employment) should be further rewarded for their crimes with taxpayer-funded health insurance. But that's what Reid's Senate health bill is likely to do: Add another reward to illegal aliens, create another incentive for more illegal immigration, and wallop American taxpayers with additional burdens in the tens or hundreds of billions of dollars, while interfering with Americans' own health care.

Section 1411 requires verification of one's eligibility for parts of the new health regime: participation in the "exchange" that will regulate people's access to health coverage and qualification for the premium subsidy tax credit. It also verifies one's eligibility for relief from cost-sharing burdens and exemption from the mandate that everyone have health insurance (illegal aliens are exempt from the individual mandate). That is, this bill applies verification to use of the exchange and thus access to health coverage, as well as the taxpayer subsidy. But while on-line verification is required, the bill fails to specify that the SAVE system is the verification system used. SAVE has been around more than a decade and is used in most means-tested programs, but the Reid bill allows bureaucrats to come up with an inferior scheme.

Problems arise from reliance on merely checking a name, birth date, and Social Security number. There's nothing here or in Medicaid enrollment provisions requiring an applicant to prove that he's who he claims to be. There's no requirement to check a photo ID, a driver's license that meets the REAL ID Act's security standards, an official birth certificate or green card, fingerprints, or anything that would prevent fraud and abuse. Bet that "Jose Smith" will have his information verified and cleared for taxpayer-funded health care — time and time again, just like the repeated usage of 000-00-0000 as a supposed Social Security number that millions of illegal aliens give their unscrupulous U.S. employers.

There's also the problem of the "flexibility" provision on page 277. It allows Health and Human Services to "modify" at will (read: dumb down) the verification process to "reduce the . . . burdens on the applicant." And the bill imposes strict "confidentiality" fetters on HHS. If an illegal alien is discovered in the verification process, that lawbreaker's information cannot be shared with law enforcement to hold illegal aliens accountable for their immigration and other offenses.

All in all, the Senate health bill gives the façade of eligibility verification. But it's far from water-tight and subject to massive, expensive fraud, abuse, and exploitation. The verification looks to be present mostly to help the bill along in the Senate. It's not likely to be tightened up. Even if it is, the House-Senate conference committee will likely strip out meaningful verification. If by some miracle or political machinations something like the Reid verification scheme were enacted, the administration could quietly gut it upon implementation.

Topics: Health Care