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More on the Joe Wilson Fiasco - Illegal Immigrants Really Won't Get Insurance Under the Bill

September 10, 2009 - by Donny Shaw

By now, whether you watched the speech last night or not, you’ve probably heard that a member of Congress, Rep. Addison “Joe” Wilson [R, SC-2], shouted “You lie!” in response to President Obama’s statement that healthcare reform will not subsidize insurance for illegal immigrants. Last night after the speech, Conor posted on this blog an explanation of why the President is right and Wilson is wrong – the bill specifically bans illegal immigrants from receiving funds under the bill. The prohibition is contained in sections 246, entitled “No Federal Payments for Undocumented Aliens.”

But as you can see form the comments on Conor’s post, this is not enough to quell concerns.

Conservatives, for example Ed Morrissey at Hot Air, cite a non-partisan Congressional Research Service report (pdf) to back up their claims that, despite the legislative text to the contrary, the bill will cover illegal immigrants. “Since HR3200 doesn’t require people to establish citizenship or legal residency before applying to exchanges for health insurance, including the public option, taxpayer money will certainly flow to illegal immigrants,” Morrissey writes.

The CRS report does in fact state that “H.R. 3200 does not contain any restrictions on noncitzens—whether legally or illegally present, or in the United States temporarily or permanently—participating in the Exchange.” But being able to participate and buy insurance through the Exchange would not make it possible for illegal immigrants to get their insurance subsidized. They would be able to purchase insurance through the public option, but they would have to pay full market rates for the policy. The public option and the exchange are available to everyone who is shopping for healthcare, whether they are receiving subsidies and affordability credits or not.

A critically important point here is that the public option will not be federally funded. It will be funded entirely by premiums paid by individuals, just like private insurance companies are. The bill does authorize $2 billion in start-up funds for the public option, but it stipulates that the money must be paid back within two years of the public option taking effect.

Ed Morrissey also brings up a second point in his post at Hot Air. He says that even though the bill specifically bans illegal immigrants from receiving subsidies in the form of affordability credits, it doesn’t provide a strong enforcement mechanism. Indeed, the CRS report states, “absent of a provision in the bill specifying the verification procedure, that the Commissioner would be responsible for determining a mechanism to verify the eligibility of noncitizens for the credits.” The CRS does not say that they think the Commissioner would fail to create a strong enforcement mechanism. That’s all Morrissey. Under the bill, the Commissioner will be required by law to create a mechanism complying with the bill’s requirement that “nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.” You can argue that the Commissioner will fail in this respect, but that would be an abdication of the law as passed by Congress, not a function of the legislation.

Congress could go a step further and spell out their own enforcement mechanism for making sure illegal immigrants don’t get insurance subsidies. Perhaps they should if they think they can do a better job that the Commissioner. But based on the House healthcare bill as currently written, any illegal immigrant receiving insurance backed by federal dollars under the bill would be a failure of government officials in implementation, not a failure of Congress in legislating.

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