Monday, January 04, 2010

Oh, Sure

The Senate health care bill, according to David Dayen at Firedoglake, would "ban undocumented immigrants from purchasing insurance coverage on the exchange, even with their own money, and which would delay legal immigrants from using the exchanges for five years."

Have no fear. Representative Luis Gutierrez (D.-IL) of the Congressional Hispanic Caucus won't let that happen, according to his office's statement, itself collared in November by Firedoglake:

It is no secret that I have been critical of proposals that would exclude our nation’s hardworking immigrants from the health care exchange, and I would find it extremely difficult if not impossible to vote for any measure that denies undocumented workers health care,” said Rep. Gutierrez. “If we bar the immigrant community from buying private insurance with their own money, we relegate them to emergency room care at the highest cost to taxpayers and deny them the important opportunity to demonstrate their commitment to a healthier America. Immigrants are prepared to pay into the system. I hope my colleagues in the Senate will defer to the language in the House bill on this issue and bear in mind that excluding immigrants from the private marketplace runs counter to the very goals of health care: containing costs, increasing the use of preventative care and streamlining the health delivery system.

He "would find it extremely difficult if not impossible to vote for" such a measure. Would find. Extremely difficult. It sounded a little weak at the time- hardly a Shermanesque statement. And now we read that sources have told Talking Points Memo

that members won't admit it publicly but they are ready to concede on immigration in the health care bill. Political aides in the White House have told key parties in Congress that President Obama wants to see a bill this year, and negotiations are under way for how it would be written.

A source familiar with the negotiations between Congress and the White House told TPMDC the Congressional Hispanic Caucus will demand an agreement from Obama that health care coverage for illegals who earn a path to citizenship will be addressed in an immigration bill.

The Senate's health care bill bars illegals from any sort of coverage, a provision embraced after Rep. Joe Wilson (R-SC) shouted "You lie!" during Obama's address to Congress when the president said that illegals would not be able to get health care under the legislation.

Those familiar with the talks say any immigration legislation will include various amnesty provisions to allow for health care coverage.

Lawmakers want to be careful they aren't viewed as giving up on a key goal, but have said they are confident the White House is being honest that Obama wants to see a comprehensive bill this year.

A source told us that members who have championed immigration reform "aren't actually conceding, just changing tactics" to secure coverage for illegal immigrants whatever way they came.

The good news is that permitting illegal immigrants to purchase health insurance coverage with their own money (if that is the outcome) in the exchange would avail them of cheaper insurance with more options than otherwise in the private market. And help keep them out of the hospital emergency room, which would benefit them, and everyone.

But relying on inclusion of such a provision in a bill providing comprehensive illegal immigration reform faces at least two obstacles. If the Obama administration pushes for illegal immigration reform, Congress, led by the GOP, will balk and may eventually vote down the measure, assuming it even makes it to the floor. And then there is the matter of placing faith in one President Obama (let alone averting the roadblock which is his chief of staff).

As Politifact has noted, the President has followed through on some of his promises. One of the more brazen inconsistencies with objective reality, however, is in the matter of health care deliberations, for which candidate and President Obama said he would

have all the negotiations around a big table. We'll have doctors and nurses and hospital administrators. Insurance companies, drug companies -- they'll get a seat at the table, they just won't be able to buy every chair. But what we will do is, we'll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process.

And about that public health care option, negotiation by Medicare of prescription drug prices, importation of prescription medicine from abroad, and lower health insurance rates? With the (unlikely) exception of the first: not happening. Not now. Not under this President. Perhaps we will get those things promised by candidate Obama when there are a Democratic President, Democratic House, and Democratic Senate.

Perhaps the Congressional Hispanic Congress will get comprehensive immigration legislation providing adequate access to health care for immigrants, legal and illegal. But the members would be wise to take their cue from Joe Lieberman, Ben Nelson, and, well, Joe Wilson and leverage their influence. As to the alternative- relying on any promise from Barack Obama- good luck.

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