Posted by: Jeff | September 11, 2009

The Loophole Question

As Joe said, we’re hard at work cutting together a new podcast on the public option. In the meantime, we’ll hopefully be bringing you some blog posts on other specific pieces of the health care debate. My first contribution, on the question of illegal-immigrants and health care:

The contention that illegal immigrants will be covered at taxpayers’ expense via a loophole in the health care bill currently in the House – a contention given concise and now-infamous voice by one Representative Joe Wilson during Obama’s speech on Wednesday – seems to have arisen from two different sources.

The first is the claim that a provision in the bill extending the health care subsidies to the family of any eligible person will allow illegal immigrants to be smuggled into the system via a legal relative. As far as I can tell, critics are referring to Section 242, which reads in part:

Except as the Commissioner may otherwise provide, members of the same family who are affordable credit eligible individuals shall be treated as a single affordable credit individual eligible for the applicable credit for such a family under this subtitle.

“Affordable credit eligible individual” means someone who qualifies to receive subsidies to help with purchasing insurance. The thing is, Section 242 is part of Subtitle C, and Subtitle C ends with Section 246:

Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

Pretty clear cut, no?

The second source for the loophole meme is the complaint that there is no method for verifying citizenship when determining who is and isn’t eligible. Which isn’t exactly what critics claim – that illegals will be covered – merely that a certain amount of illegals will probably wind up unintentionally covered because we aren’t checking citizenship. Anyway, unlike the first complaint, this does appear to be true. But there are complications, plenty of them purely practical.

First off, lots of poor Americans often have a hard time producing identification or proof of citizenship, for completely understandable reasons that are just part and parcel of being poor. Requiring proof of citizenship would prevent many of them from receiving coverage, which is rather perverse given that the poor are among those who need health care relief the most. Second, even for people who aren’t poor, it’s a hassle. I mean, how would you like to have to get your identification papers together, on top of everything else, every time you went looking for new health coverage? Third, systems for verifying citizenship don’t just arise out of the ether. They require records and manpower and bureaucracy, all things which come with added costs, inefficiencies and logjams.

This brings us to the Heller Amendment, which was introduced by the House Republicans to try and get around this problem. Basically, it would require private insurance companies to verify the citizenship of anyone who purchases insurance from them. In order to do so, it granted them access to the Income and Eligibility Verification System (IEVS) and the Systematic Alien Verification for Entitlements (SAVE) programs. Both systems draw their information from the Internal Revenues Service and the Social Security Administration, among other things.

Let’s repeat that. The Heller Amendment would have granted insurance companies access to the private Social Security information and tax records of Americans. It would have been an unprecedented thing, and the House Democrats quite rightly voted it down. Which allowed the Republicans to demagogue about illegals benefiting at taxpayer expense. And now, the worst part is that Max Baucus and other moderate Senators appear to have been sufficiently spooked by Rep. Wilson’s outburst and the looming threat of anti-immigrant sentiment that they are caving to demands for a proof of citizenship requirement.

So someone needs to ask Representative Joe Wilson and his ilk (and I guess Max Baucus and Kent Conrad by extension) what is more important to them: A health care system that functions smoothly, covers everyone who needs it, is cost-effective and doesn’t grant businesses unprecedented access to Americans’ private information? Or a health care system that indulges petty and vindictive nativism? Because they can’t have both.

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