Monday, June 03, 2013







Health Care And Now Immigration

A while back,I wrote "Joan Walsh is a national treasure (though I reserve the right to criticize her in the future)."  Commenting on the application of President Obama's contraception regulations to Roman Catholic institutions, Walsh revealed "a singular understanding that one institution, the United States Conference of Catholic Bishops, speaks for itself, has been wrong, and has wronged its constituents, who deserve better." (Is there a special place in Hell for people who quote themselves? I hope not.)

It's sixteen months later, and Joan Walsh still understands what others don't.   Walsh has noticed that Democrats are willing to concede almost anything to obtain a super-super majority in the Senate, and she's blowing the whistle on them. Recognizing the "dynamic" that is playing out as Democrats strive to make comprehensive immigration reform palatable to Republicans, Walsh remarks

Gang of Eight leader Chuck Schumer told Politico, “Our goal is to get 70 votes. It is going to take a lot of work.” His GOP partner John McCain agrees. Supposedly 70 votes is the magic number that will shame enough members of the crackpot House GOP majority into supporting it when it gets to their chamber. But how bad will the bill have to get to reach that goal? (Also remember that the artificial 60-vote super-majority requirement is already a GOP-imposed barrier to progressive reform.)

She quotes a kindred spirit, America’s Voice executive director Frank Sharry, who wrote in a statement “We would remind them that it’s far better to pass a good bill with 60-70 votes than a hopelessly compromised bill with 70-80 votes. The Senate bill is already a carefully balanced compromise between the right and the left.”

It's unlikely, however, that Sharry or virtually anyone on the left other than Walsh has noticed

The immigration reform bill isn’t the only example of this dynamic. The Affordable Care Act incorporated more than 150 Republican amendments during the Senate committee process – and didn’t get a single Republican vote. Important liberal priorities like the public option, letting people buy into  Medicare before 65 and greater bargaining power to lower prescription drug costs all got traded away in search of nonexistent GOP support. I was pilloried by other liberals,on “Hardball” and on Twitter, for even briefly suggesting that no bill might be better than a bad bill. Same with the deals that ended the debt-ceiling hostage crisis – the “sugar-coated Satan sandwich” – and postponed the “fiscal cliff.”

Aside from the Rube Goldberg-nature of both immigration reform and health care and the major concessions made by liberals (allegedly) to improve chance of passage of the initiatives, there is a more specific connection between the Affordable Care Act and the Border Security, Economic Opportunity, and Immigra- tion Modernization Act (text here).  John Judis explains

Just look at the tortuous way the bill deals with immigrants’ access to the Affordable Care Act. The bill denies health insurance coverage to the eleven million undocumented workers, who will become “registered provisional immigrants” (RPIs), and to over 100,000 guest agricultural workers (who will get “blue cards” rather than “green cards”). Only after immigrants become permanent residents, which in the case of the eleven million undocumented will take a minimum of ten years and as long as 15 years, will they become eligible for Obamacare.

This is obviously bad health policy. Low-skilled immigrants who work in physically strenuous and polluted settings will be denied preventive coverage and treatment for chronic diseases, and if they acquire serious illnesses—tuberculosis, cirrhosis of the liver, and several cancers are common among immigrant farm workers—they will have to go to sequester-squeezed emergency rooms.

But it’s also bad economics. It creates an incentive for employers to hire the new immigrants over citizens or green-card holders and to provide neither with health insurance. Under the Affordable Care Act, employers with fewer than 50 workers do not have to buy health insurance for their employees, but businesses with 50 or more workers—which employ about three-quarters of American workers—either have to provide insurance or pay a fine for those workers who buy insurance through the exchanges the act creates. The fine is ordinarily $2,000 but can run as high as $3,000.

Businesses with 50 or more employees that choose to pay a fine rather than provide insurance will not have to pay fines for the RPIs or blue-card holders because they are not eligible for the exchanges. So employers will be able to save from $2,000 to $3,000 a year by hiring a new immigrant over an American citizen. For salaries that hover between $15,000 and $25,000, as they do in many immigrant-heavy industries, that’s no small savings. Even an advocate for low-income immigrants sees the language as a potential problem: “We don’t want them to hire immigrants over citizens because of that loophole,” says Sonal Ambegaokar, who analyzes health policy for the National Immigration Law Center. “We want a level playing field.”

The bill’s denial of coverage doesn’t only give immigrants an advantage over citizens when it comes to new hires. It also gives larger businesses that employ immigrants a reason to drop insurance altogether. If they offer insurance to one employee, they need to offer it to all employees, including immigrants. But if they deny it to everyone, they’ll only pay fines for workers who are citizens.

Denying health insurance coverage to employed illegal immigrants is a critical provision, one for which neither Senate Democrats wishing to accommodate their GOP colleagues nor those conservatives themselves are responsible. Judis continues

This all could have been avoided if Obama care had just insured undocumented immigrants in the first place. But in the fall of 2009, the administration, facing charges from Republicans that the health care bill secretly funded “illegal immigrants,” urged Senate Democrats to bar the undocumented from coverage. The administration, fearful of political trouble, reflexively carried this over to its own immigration-reform proposals. “The point was to get immigration done,” one White House official told me.

So we come full circle.  "The point was to get immigration done," the Administration believed two-and-a-half years ago.   Now, Gang of Eight leader Wall Street Schumer cites his goal as to get 70 votes, as if House Republicans care more about what Senators (not their favorite group of individuals) do than what either their corporate base or their popular base thinks about the legislation.  Pursuit of a magical 70% is so silly as to make one suspect that Democratic Senators, one eye focused on wealthy donors, are pleased to see the bill fashioned so as to drive down the wage rate.  Alas, in consideration of Occam's Law, passage of legislation for thes ake of passage of legislation  is a more likely motive.
   
Walsh argues, convincingly, "Democrats ought to hold the line" because "abandoning ever-larger categories of potential beneficiaries of the bill... is bad for undocumented immigrants, and bad for Democrats, too."   It is, she might have mentioned, bad for workers, thus bad for America, too.

We come full circle.  "The point was to get immigration done," the Administration believed two-and-a-half years ago.   Now, Gang of Eight leader Wall Street Schumer cites as his goal to get 70 votes, as if House Republicans care more about what Senators (not their favorite group of individuals) do than what either their corporate base or their popular base thinks about the legislation.  Democratic Senators, one eye focused on wealthy donors, may be pleased to see the bill fashioned to drive down the wage rate.  Clearly, however, they want a bill to get done.  Any bill.

Walsh argues, convincingly, "Democrats ought to hold the line" because "abandoning ever-larger categories of potential beneficiaries of the bill... is bad for undocumented immigrants, and bad for Democrats, too."   It is, she might have mentioned, bad for workers,and thus for America, too.




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