ICHIA Provisions Stripped From Medicare Bill Signed By President

IMMIGRANTS & PUBLIC BENEFITS

Health Care

ICHIA provisions stripped from Medicare bill signed by president
Immigrants' Rights Update, Vol. 17, No. 8, December 18, 2003

Provisions that would have allowed states to provide health coverage through Medicaid and the State Children's Health Insurance Program to lawfully present children and pregnant women, regardless of their date of entry into the United States, had been stripped from the recently passed Medicare bill by the time Congress voted to approve it. The controversial bill, which President Bush signed on Dec. 8, 2003, adds a prescription drug benefit for some elderly and disabled Medicare recipients and, in a move to begin privatizing Medicare, makes federal subsidies available to private insurance companies that offer health plans to people who are Medicare-eligible.

The provisions that would have benefited immigrant women and children (known to advocates as the Immigrant Children's Health Improvement Act (ICHIA) provisions) had been included in the Senate-passed version of the Medicare Prescription Drug, Improvement and Modernization Act of 2003. Under the ICHIA provisions, beneficiaries would no longer have been subject to sponsor "deeming" or liability. Deeming rules count the income and assets of an immigrant's sponsor as available to the immigrant for purposes of determining the immigrant's eligibility for certain public benefits.

The ICHIA provisions were included in the Senate version of the Medicare bill despite opponents' efforts to eliminate it in the Finance Committee and on the Senate floor. Among the provisions' chief champions was Sen. Max Baucus (D-MT), who was a member of the conference committee charged with reconciling the House and Senate versions of the Medicare bill. The ICHIA provisions remained on a short list of undecided issues even as conference committee members announced that they had reached a compromise. In the last 24 hours before the bill was to be voted on by the House, strong opposition to the provisions by mostly Republican immigration restrictionists won the day, and they were stripped out of the final package.

However, the final package includes a provision introduced by Sen. Jon Kyl (R-AZ) that, beginning in 2005, provides for $250 million a year over four years to reimburse hospitals, physicians, and ambulance service providers for care provided to undocumented immigrants. Two thirds of the funds will be allocated to states based on federal government estimates of the number of undocumented individuals in each state. One third of the money will be distributed to the states with the highest rates of apprehensions of undocumented people. The payments are to be made directly to providers.

However, in return for agreeing to vote in favor of the Medicare bill, Rep. Dana Rohrabacher (R-CA) extracted a promise from House Speaker Dennis Hastert (R-IL) to allow a vote on a provision Rohrabacher has put forward that would require health care providers to report any undocumented immigrants to federal immigration officials within two hours of providing treatment or services to them. Health care, immigrant rights and faith-based advocates, hospital groups, and congressional leaders from both sides of the aisle have strongly criticized the provision and vowed to mount a vigorous campaign to ensure its defeat when it comes to a floor vote next year.