Steve Reads

For my sins, I periodically visit Michelle Malkin’s blog. (I won’t dignify it with a link; you can google it.) It is a swamp. Somewhere in there, she links to a blog entry purporting to show that “Obamacare” actually will cover illegal immigrants.

Fortunately for us, that piece links to the Congressional Research Service piece — “Treatment of Noncitizens in H.R. 3200″ — on which this claim is based. (And just to trace this back to its utterly trivial beginnings: people seem to care about this because that dude yelled “You lie!” during Obama’s speech last night. The dude’s name will quickly be forgotten. This country’s hatred of poor brown people will not.) I have done you, my belovèd readers, the favor of excerpting below most of the bits from that report which relate to illegal immigrants. The big takeaways:

1. Illegal aliens are required to carry health insurance. This doesn’t mean they would receive any money.
2. Aliens — legal or otherwise — would have access to the Exchange, just like everyone else. That is, if they didn’t have insurance from some other source, like an employer health plan or Medicare, they could shop in the Exchange. This still doesn’t mean they would receive any money.
3. Immigrants can only receive money if they’re here legally. This leaves open the question — which the report doesn’t address — of whether they’ll still be required to pay for insurance even if they can’t afford it. That is, will poor illegals be even more screwed than they already are?
4. The bill itself doesn’t set eligibility requirements, but leaves that up to a Commissioner. Big whoop. I’ll wait a couple days and let the web tell me how many other bills leave minor (yes, this is minor) implementation details up to a technocrat.
5. Illegal aliens can still receive emergency Medicaid. I don’t know what the details here are, though I’ll look them up presently. It sounds to me like the idea is: if you go to an emergency room and you need an appendectomy, but you can’t afford it, Medicaid will help you for five years, regardless of your immigration status.

Item 4 is the one that the right, apparently, is incensed about. That must be what they’re incensed about, because there’s nothing else that could rationally upset them here — unless, that is, they’re actually going to raise a stink about emergency Medicaid.

There’s nothing here, folks. This story is classic Malkin material: come up with some nickname for an Obama plan that suggests there’s unexamined sleeze somewhere deep within; dig around for one right-wing blog or another to justify your claim. After clicking down through various links to an actual authoritative source, it turns out that there’s no there there. (Alternatively, invent your own news network whose talking heads you christen as authoritative.)

As I mentioned, the bits about illegal immigrants are included below.

Thus, it would appear that unauthorized aliens who meet the substantial presence test would be required under H.R. 3200 to have health insurance.

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To be eligible for the credits under §242 of H.R. 3200, individuals must be lawfully present in a state in the United States, but generally not in the United States temporarily (i.e., nonimmigrants).

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For example, in a family consisting of a U.S. citizen married to an unauthorized alien and a U.S. citizen child, the U.S. citizen spouse and child could meet the criteria for being a credit- eligible individual, while the unauthorized alien spouse would not meet the criteria.

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Some have expressed concerns that since H.R. 3200 does not contain a mechanism to verify immigration status, the prohibitions on certain noncitizens (e.g, nonimmigrants and unauthorized receiving the credits may not be enforced. However, others note that under §142(a)(3) of the bill, it is the responsibility of the Health Choices Commissioner (Commissioner) to administer the “individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.” Thus, it appears, 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.

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In addition, this change could also mean that more noncitizens who meet the categorical and income eligibility standards for Medicaid but are barred due to their immigration status (e.g., nonimmigrants, unauthorized aliens) would be eligible for emergency Medicaid (discussed below). Notably, the House Energy and Commerce Committee added a section to H.R. 3200 that reiterates current law that unauthorized aliens are not eligible for full-benefit Medicaid coverage.

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All aliens regardless of status who otherwise meet the eligibility requirements for Medicaid are eligible for emergency Medicaid.

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Emergency Medicaid may pay for the care of unauthorized aliens, nonimmigrants, and LPRs within the first five years of arrival (or longer if the state does not exercise the option to provide coverage for LPRs after the five years) for emergency conditions if they meet the other eligibility requirements of the Medicaid program. Specifically, aliens who are otherwise eligible for Medicaid except for their immigration status (e.g., unauthorized aliens, nonimmigrants) may receive “medical assistance under Title XIX of the Social Security Act … for care and emergency services that are necessary for the treatment of an emergency medical condition (as defined in Section 1903(v)(3) of such Act) of the alien involved and are not related to an organ transplant procedure.”