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What The Congressional Research Service Report Really Says About Immigrants And Health Care Reform

77745389_5dc2b84dd6Shortly after the Congressional Research Service released their report on the treatment of noncitizens in the House health care bill, the anti-immigrant hate group, Federation for American Immigration Reform (FAIR), was already patting itself on the back. “Case closed. Illegal aliens will be eligible to participate in the health care program offered by the House bill unless Congress acts to amend the bill,” stated Dan Stein, president of FAIR. However, CRS’ analysis was much more nuanced than Stein would like to admit and — if anything — it highlights how the health care bill could actually hurt undocumented immigrants more than it helps them in the absence of any major reform of our immigration laws.

Sec. 242 and 246 of America’s Affordable Health Choices Act of 2009 explicitly state that only individuals who are lawfully present in US will receive any of the benefits provided in the bill. Stein is right that the CRS points out that the bill does not contain a mechanism to verify immigration status. Yet he downplays a key point of the report: under §142(a)(3), the Health Choices Commissioner is responsible for determining the eligibility of individual affordability credits which implies that he’ll also have to determine the mechanism to verify the eligibility and immigration status of noncitizens.

CRS’ analysis is pretty much in line with what others have been saying. Edwin Park of the Center on Budget and Policy Priorities and Jonathan Blazer of the National Immigration Law Center have both asserted that verification mechanisms for the new subsidy program will be determined during the implementation process (after the bill is passed) which allows the government to choose the “mechanism [which] best matches the underlying process for getting a subsidy.” The report also points out that nothing in the House bill overturns the precedent set by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act which prohibited undocumented immigrants from being eligible for most public benefits and even severely restricted the eligibility of legal immigrants. It should also be noted that, in the case of Medicaid, stringent verification mechanisms are known to have barred more American citizens than undocumented immigrants at a high cost to taxpayers: for every $100 spent by taxpayers to implement documentation requirements in six states, only 14 cents were saved.

The report also exposes one of the more problematic aspects of the bill’s treatment of noncitizens. The House bill currently mandates that all citizens as well as “resident aliens” must have health insurance. However, “resident alien” is a term defined by tax, not immigration law and it includes undocumented immigrants who meet the “substantial presence test.” That means that all undocumented immigrants who fall into the category of “resident alien” would be required to obtain health insurance and will be fined if they fail to do so. However, that doesn’t in any way imply that the government is going to help them since only individuals who are lawfully present in the United States are eligible for any of the federal assistance provided in the bill. Ultimately — if the nation’s broken immigration system isn’t addressed — the proposed health care bill essentially penalizes undocumented immigrants for not having insurance that they won’t even have access to in the first place.

With that said, the CRS report ultimately sheds more light on the desperate need for immigration reform that addresses the problem of current and future flows of unauthorized immigration as opposed to the deficiencies of the House health care bill related to its treatment of noncitizens. While anti-immigrant activists continue to exploit health care reform to recruit support for their nativist agenda, the smartest way to approach both issues would be to pass immigration reform and turn uninsured undocumented immigrants into legal residents who pay into the system.

Hayes: Time For A New Church Committee

cia-lobby-sealIn an excellent article on the legacy of the Church Committee, the mid-1970′s investigation of U.S. intelligence community abuses, Chris Hayes looks at the possibility of a similar investigation under President Obama:

Obama has insisted, routinely, unwaveringly, that he is “more interested in looking forward than…in looking backwards.” At one level this seems a shocking abrogation of the executive branch’s chief constitutional responsibility, to “take care that the laws be faithfully executed.” But presumably the thinking goes something like this: the president has a limited amount of political capital, and he can spend it on major, once-in-a-generation reforms of the American social contract — universal healthcare and cap and trade — or he can spend it pursuing justice for the perpetrators of the previous administration’s crimes. As morally worthy as the latter might be, it won’t get anyone healthcare or stop the planet from melting; it won’t provide a new foundation for progressive governance.

But as self-consciously pragmatic as this posture is, it’s proving wildly impractical to implement. The reason is that the White House has limited control over when and what is revealed about crimes and misdeeds of the Bush years, and every time a new revelation hits the papers, such as the recent disclosures of Blackwater’s involvement with the CIA assassination unit and interrogators’ use of “mock executions,” it dominates the news cycle. Since the White House itself has defined such revelations as a “distraction,” every time they are in the news it is, by its own definition, distracted.

The benefit of a new Church Committee would be that it would corral these “distractions” into a coherent undertaking, initiated in Congress, within a fixed time period. It would also provide a framework for systematic investigation of the policies rather than selective prosecutions of those at the bottom of the hierarchy who carried them out.

I find this pretty convincing. I’ve been concerned about such an investigation for precisely the “self-consciously pragmatic” reasons Hayes describes. I think we shouldn’t pretend that what we have here are simply questions of the law — any investigation of this sort is an inherently political enterprise, one that could have serious negative consequences for the progressive policy agenda. As I told NPR for this story, it would be darkly ironic if the Bush administration were, through its past criminality, effectively able to stymie Obama’s broader agenda by causing him to expend valuable political capital to investigate that criminality.

I think, though, that the enormity of the abuses, the fact that they go deeper than the Bush administration, as well as the fact that, as Hayes notes, Obama’s desire to “look forward” has not saved him from having to look backward with every new revelation, all argues for the sort of investigation that Hayes describes. I think the main goal here has to be to ensure that the U.S. never again utilizes torture, and it’s hard to see how that will be achieved without accountability for those who sanctioned the torture.

It’s in the nature of governing institutions to accrue greater power while resisting greater oversight and accountability. This is a central conservative insight, one that animates much of their hysterical opposition to health care reform, so it’s strange that conservatives seem to be the most resistant to applying it to executive overreach on intelligence. Broadening such an investigation beyond just the Bush administration may diminish some of that resistance, but I’m not sure how much.

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