It never occurred to me that one needed to fact check such an obvious lie.

Gonzone, buddy, we need to “fact check” everything if we want this puppy to pass, but damned if that isn’t turning out to be a chore for us amateurs…

Brant, I think you're right that Obama's speech Wednesday night centered on the bill he'd like to see adopted. He was not, I didn’t think, plugging HR 3200 specifically. As you point out, that leaves us unable to “fact check" the assertions he made about this as-yet unwritten bill.

However, in cross-referencing the text of HR 3200 against all those bill section numbers and/or bill page numbers appearing in this week’s coverage on the Wilson outburst, it’s clear that Wilson's objection was specific to HR 3200.

So the two men really are commenting on two different pieces of legislation, present and future.

I'm thinking since Wilson voiced a concern for loopholes in the stagnant HR 3200, AND since HR 3200 could be resuscitated, AND since accusations of similar loopholes could arise in any other bill introduced, too…it makes sense to go over HR 3200 pretty closely?

To that end, Up Goose Creek, Wilson appears to be correct that HR 3200 would allow illegal immigrants to purchase insurance through the “national health insurance exchange,” including any “public option” coverage that would become available through that "exchange." The PolitiFact.com piece Eric linked confirms it, and they cite a Congressional Research Report from August that confirms it, too.

However, the PolitiFact piece also points out 1) illegal immigrants can presently purchase private health insurance directly at the same rates everyone else pays, and 2) if they instead chose to purchase either private coverage or the “public option” coverage through the “exchange,” they would still pay the same rates everyone else participating in the “exchange” pays.

Of course, Obama has assured us that any “public option” provision in the bill he’d like to see passed would be self-sustaining, as in costs of coverage would be fully covered by participants’ cost of premiums. I haven’t been able to confirm whether HR 3200 offers taxpayers the specific assurance that the “public option” will be self-sustaining. (Anybody?)

As it relates to HR 3200, then, the matter of illegal immigrants buying private coverage through the “exchange” is a non-issue. I suppose the matter of illegal immigrants buying “public option” coverage through the “exchange” is an issue only if that “public option” component is not self-sustaining and instead turns out to be subsidized by taxpayer monies?

Meanwhile, several of the articles Eric linked cite prohibitions against illegal immigrants utilizing “affordability credits.” (Do these flow through our personal income tax returns, or what?) Per those citations, I was able to find two such prohibitions in HR 3200 at page 132, Section 242 and at page 143, Section 246.

The PolitiFacts piece Eric linked, though, in turn links a response they received from Federation for American Immigration Reform (FAIR), which PolitiFacts commends as quite thorough. FAIR objects that although HR 3200 prohibits illegal immigrants from claiming “affordability credits,” it contains no device for enforcing that prohibition.

We’ve already read about Congress rejecting two amendments that might have outlined enforcement provisions for collecting the “affordability credit,” FAIR cites some good enforcement provisions the Feds used to oversee those stimulus rebates last year, and I also read somewhere (?) that Medicaid’s enforcement provisions for barring illegal immigrants, a recent enhancement, are quite explicit. Sarge, to answer your question, HR 3200 doesn't even call for applicants' self-attestation of legal residency, absent any verification. I’m wondering, then, why Congress rejected both of those amendments?

In a final objection I’d heard nothing about previously, FAIR cites an ambiguous phrase in HR 3200 relating to the “affordability credit.” Per their reference, I found it at page 133, Section 242(a)(2). It states “members of the same family shall be treated as a single affordable credit individual eligible…,” so they question whether a single legal immigrant in a family of illegal immigrants could entitle all family members to utilize the “affordability credit.” It sounded like a reasonable question to me?

In my (un)professional opinion, I’m starting to think there are enough omissions and ambiguities in HR 3200 that Obama would be wise to avoid regurgitating them in any new bill he should promote.

You are as bad as Joe Wilson, only Wilson has gotten hundreds of thousands of dollars from insurance and healthcare interests for his troubles and you've gotten nothing but a twisted ideology.

What cruel person would refuse emergency care to a human being?

You parse yourself into nonsense, while refusing to accept that the bills in both houses contain exclusions for illegal aliens.

If they look or talk differently, then assume they are liars and illegal aliens and shoot them on the spot. No more need for health care.

But get ready to pick you own damn tomatoes!

Alternatively, we could follow the examples outlined in the Bible and not treat the alien or stranger any differently than we do our family, friends, and neighbors. Of course this means ignoring the haters who want to blame all the problems of the world on those who are different than themselves.

"If ignorance is bliss, why aren't more people happy?"

Many posters on this site often bring up the bible in their posts, can you tell me why?

That is exactly how I heard it which brings up the question are we planning to deny them the treatment they already receive from our hostpital emergency rooms?

Certainly we should not deny compassionate care and perhaps healthcare savings and lowered costs will mean our charity dollars (public and private) will stretch further to help these people.

On the other hand, I am not confident that any of the current reform plans will actually lower costs (perhaps when the president gives us his plan or fleshes out the one he outlined in his speech we will know more).

Medicare and Medicaid have not lowered the cost of healtcare - rather the government just quit paying as much for services rendered and limited what procedures and medicines were eligible (this has resulted in a huge cost increase to those of us on private or non-government healthcare plans).

I wonder how this will be handled.

First, as one new to KV is it customary that one should go back in time to read every post in order to avoid making the mistake I made in thinking that each thread is somewhat self-contained. If so I apologize for saying no one had posted a direct link to the health care bills. I should have said that in this thread no one posted direct links.

Now here is where I do need your help. I read every page from the first to the last mention of INDIVIDUAL AFFORDABILITY CREDITS. Can anyone tell me what in the heck is an INDIVIDUAL AFFORDABILITY CREDITS and how does not getting any stop someone (like an illegal alien) from getting US taxpayer subsidized health care or medical treatment?

I am not being sarcastic just don't have time to ferret out the answer and thought someone could lend a hand. I really am trying to figure out this health care dilemma.

Excellent work - saved me a lot of time.

Now be so kind as to show me in the bill how hospitals and doctors can determine who is and who is not eligible based on citizenship?

Again, thanks for helping this poor soul. Your progressive compassion and kindness for the less astute is refreshing. You are an inspiration.

I shall henceforth think of you as "Saint redmondkr".

To my knowledge no one (including me) on this thread or any other is advocating that sick people not be allowed access to health care.

To me there are only two issues:

Since the president announced that illegal aliens would be excluded from taxpayer funded hearth care I have wondered how this will work.

On the other hand, if we are going to continue to do the correct, moral, and just thing by providing access to healthcare to everyone who shows up at an emergency room, I wonder who will pay for it? A secondary question would be how many non-citizen, non-taxpaying people can US taxpayers support.

Virgil Proudfoot said (on Friday): It would probably cost a lot less money simply to provide healthcare to foreigners than to build a whole governmental bureaucracy to figure how to deny it to them.

Weeell, you may have a point there, Virgil. I just stumbled across this, in a CBS story to the effect that the Senate is now planning to add a citizenship verification process to their reform bill:

"In the case of six states where the (Medicaid) program was reviewed by a congressional committee, the Times reports, verification increased federal costs by $8.3 million but only detected eight illegal immigrants using Medicaid."

(link...)

(And from the article, follow addl links to specific studies.)

(And particularly read this one from the GAO documenting lower enrollment of eligible citizens, especially elderly who may lack original birth certificates, etc. (link...).)

Under the Dem proposal, undocumented workers wouldn't even be able to BUY health insurance under this "exchange" thingie

To what "Dem proposal" are you referring, Virgil?

If you're talking about the bill Obama says he'd like to see passed, yes, I heard him say that, too.

If you're talking about HR 3200, though, it looks to me like undocumented workers CAN buy insurance, including "public option" coverage," through the "exchange."

Here's what the PolitiFacts piece Eric linked says on the subject:

"FAIR has a point that illegal immigrants would likely be able to buy insurance on the national health insurance exchange. We don't see anything in the bills that would hinder that. A Congressional Research Service report issued Aug. 25, 2009, confirmed our observation. The House bill "does not contain any restrictions on noncitzens participating in the Exchange — whether the noncitizens are legally or illegally present, or in the United States temporarily or permanently," the report said."

And here, in turn, is that Congressional Research Service report PolitiFacts references:

(link...)

Again, this matter is a non-issue WRT "exchange" participants' purchases of private insurance, especially since they're able to purchase the same policies directly from insurers without going through the "exchange."

It's looking to me like an issue could potentially arise only WRT "exchange" participants' purchases of "public option" insurance, and then only if we find that HR 3200 and/or some future bill shouldn't provide adequate assurances that the "public option" component be self-sustaining. That is, only under those circumstances would illegal immigrants' participation in the "public option" potentially result in a cost to taxpayers.

Whether we're talking about HR 3200 or some future bill Obama might promote, it seems a lot is riding on the final bill's ability to ensure a self-sustaining "public option" component?

I wasn't looking at this debate as a competition. There is no need for anyone to admit a mistake or gloat over a “gottchya”.

I don’t care where you come from far left or far right, we need to understand the important issue of health care reform. Tamara’s willingness to wade through the muck, boil down the data, and present it in an organized, somewhat non-partisan manner is a godsend. She is providing the tools needed to understand.

I could linger on conservative blog sites all day and night without finding a thing to challenge what I already think I know. How would this assist me to understand health care reform? How would it allow me to be a part of the solution?

So far, I have learned more on this site and have had to think more about the issues of health care than at any other source - nothing forces one to think more than having one’s beliefs challenged.

No matter the outcome, I know one thing - I will have to live within the system that comes out the other end of this process. Moreover, as it is not too late to influence the final product (letters to legislators, etc.) and as I want to contribute, I must understand what it is that I feel is important or needs changing.

For instance to me the only reason the illegal immigrant issue is important is the extent that it affects our ability to provide quality care to US citizens, i.e., the extent to which providing health care to non-residents drains resources that otherwise might be expended on citizens. If we had unlimited resources this matter would be moot. However, I believe there is a limit to how many non-taxpayers a single taxpayer can support, the fewer non-taxpayers receiving subsidized health care the less of a burden each taxpayer must carry. (As an aside, we need to find a way to ensure that non-resident taxpayers get health benefits incidentally, I would never have come to this position without the influence of liberals.

In addition, I am concerned about the extent that the final plan will create or lead to a government provided health care system. I happen to believe the government works best a regulator of not provider of services (yes, yes I understand roads and sewers but remember most roads and sewers are built by private companies).

There are many of reasons why I feel this. Mainly it comes back to my belief in what has allowed the US to flourish - capitalism. The problem has always been finding a balance between unfettered business and over regulation that is the cause of disagreement between the left and right over health care.

About the healthcare debate, I pray we find a balance between the two rather than the destruction of one.

All I'm suggesting, Gary, is that Dems moderate or liberal don't need to take that bait.

1) Non-issue: Illegal immigrants can already purchase private insurance directly from private insurers. That's a matter between them and the private insurers that does not impact taxpayers.

2) Non-issue: HR 3200 (and any future bill?) also allows illegal immigrants to purchase private insurance from private insurers through the "exchange." That's still a matter between them and private insurers that does not impact taxpayers.

3) Potential issue: HR 3200 (and any future bill?) also allows illegal immigrants to purchase "public option" insurance from the government through the "exchange."

However, that's a potential issue that could impact taxpayers ONLY if Dems fail to ensure a self-sustaining "public option" provision in HR 3200 (and any future bill?).

Dems need to take control of this debate, then, to focus it solely on ensuring a "public option" provision that is indisputably self-sustaining...and the nay-sayers won't have a leg to stand on.

No, it's the other side dangling the bait!

But I'm sitting here now double-checking that last assertion I made...

If Dems ensure a self-sustaining "public option," do we still have an obligation to tighten up elgibility for those "affordability credits," too?

That is, do the "affordability credits" offer the opportunity for some "exchange" participants to obtain their coverage at a lesser cost than others? If so, does that result in a taxpayer cost?

Also, do the "affordability credits" apply to parties obtaining their coverage outside the "exchange?" Same question as to whether that results in a taxpayer cost?

Maybe I need to understand these credits more fully. Chime in, anybody, if you can illuminate...

for the simple minded

You are right. Only the simple minded would believe that nonsense.

Very well done and humorous but misleading...

No argument about how private insurance companies operate (did laugh at how the nasty word - P R O F I T was emphasized).

And it may (haven't fact checked) be true that the Government only uses 1/2% of Medicare dollars for overhead but what about the huge unreimbursed processing costs that have been pushed down to the health care providers (ask your Doc about this)?

Yes, we like fire, police, and water but the Federal government doesn’t provide any of these services. (I would hate to think what would happen if Congress was in charge of first responders – any emergency would be over long before donor lists could be checked to determine whether to dispatch, not to mention the gerrymandering of service districts. Whew, how would Lincoln ever put out a fire?)

Fire insurance is hardly free. The cartoonist confuses the service of fire protection with fire insurance - one sends a loud bright red (or puke green) fire truck with lots of red, white, and blue flashing lights loaded with brave fire fighters to extinguish a blaze. The other, fire insurance helps pays for the damage caused by the fire.

Moreover, fire insurance is purchased (or not) by individuals or companies which brings up a rhetorical question - if fire insurance and auto insurance work without being owned and operated by the government how come health care needs to be taken over by the government (as this cartoonist seems to be advocating - regulation of is not ownership in)?

In addition, many "government" services are not government owned and operated and are never "free to all" but are always paid for by subscription, donations, and income, sales, or property taxes.

Indeed, while it may feel free to non-taxpayers, the rest of us should never make the mistake of thinking government services are "free". Everything done for us or to us by government comes at a hefty price and unlike other goods and services we can go to jail for failure to pay.

Of course, this was only cartoon and I suspect the cartoonist didn't really expect it to be taken seriously.

HR 3200
These credits could be described as "inverse credits," defined by the amount over and above a certain family income based limit that enrollees would have to pay, and paid to the Qualified Health Benefits Plan offering entity.

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Subtitle C—Individual Affordability Credits
SEC. 241. AVAILABILITY THROUGH HEALTH INSURANCE EXCHANGE.
(a) IN GENERAL.—Subject to the succeeding provisions of this subtitle, in the case of an affordable credit eligible individual enrolled in an Exchange-participating health benefits plan—
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(1) the individual shall be eligible for, in accord-
ance with this subtitle, affordability credits consisting of—
(A) an affordability premium credit under section 243 to be applied against the premium for the Exchange-participating health benefits plan in which the individual is enrolled; and
(B) an affordability cost-sharing credit under section 244 to be applied as a reduction of the cost-sharing otherwise applicable to such plan; and
(2) the Commissioner shall pay the QHBP offering entity that offers such plan from the Health Insurance Exchange Trust Fund the aggregate amount of affordability credits for all affordable credit eligible individuals enrolled in such plan.
(b) APPLICATION.—
(1) IN GENERAL.—An Exchange eligible individual may apply to the Commissioner through the Health Insurance Exchange or through another entity under an arrangement made with the Commisioner, in a form and manner specified by the Commissioner. The Commissioner through the Health Insurance Exchange or through another public entity under an arrangement made with the Commis-

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sioner shall make a determination as to eligibility of an individual for affordability credits under this subtitle. The Commissioner shall establish a process whereby, on the basis of information otherwise available, individuals may be deemed to be affordable credit eligible individuals. In carrying this subtitle, the Commissioner shall establish effective methods that ensure that individuals with limited English proficiency are able to apply for affordability credits.
(2) USE OF STATE MEDICAID AGENCIES.—If the Commissioner determines that a State Medicaid agency has the capacity to make a determination of eligibility for affordability credits under this subtitle and under the same standards as used by the Commissioner, under the Medicaid memorandum of understanding (as defined in section 205(c)(4))—
(A) the State Medicaid agency is authorized to conduct such determinations for any Exchange-eligible individual who requests such a determination; and
(B) the Commissioner shall reimburse the State Medicaid agency for the costs of conducting such determinations.
(3) MEDICAID SCREEN AND ENROLL OBLIGATION.—In the case of an application made under

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paragraph (1), there shall be a determination of whether the individual is a Medicaid-eligible individual. If the individual is determined to be so eligible, the Commissioner, through the Medicaid memorandum of understanding, shall provide for the enrollment of the individual under the State Medicaid plan in accordance with the Medicaid memorandum of understanding. In the case of such an enrollment, the State shall provide for the same periodic redetermination of eligibility under Medicaid as would otherwise apply if the individual had directly applied for medical assistance to the State Medicaid agency.
(c) USE OF AFFORDABILITY CREDITS.—
(1) IN GENERAL.—In Y1 and Y2 an affordable credit eligible individual may use an affordability credit only with respect to a basic plan.
(2) FLEXIBILITY IN PLAN ENROLLMENT AUTHORIZED.—Beginning with Y3, the Commissioner shall establish a process to allow an affordability credit to be used for enrollees in enhanced or premium plans. In the case of an affordable credit eligible individual who enrolls in an enhanced or premium plan, the individual shall be responsible for any difference between the premium for such plan

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and the affordable credit amount otherwise applicable if the individual had enrolled in a basic plan.
(d) ACCESS TO DATA.—In carrying out this subtitle, the Commissioner shall request from the Secretary of the Treasury consistent with section 6103 of the Internal Revenue Code of 1986 such information as may be required to carry out this subtitle.
(e) NO CASH REBATES.—In no case shall an affordable credit eligible individual receive any cash payment as a result of the application of this subtitle.
SEC. 242. AFFORDABLE CREDIT ELIGIBLE INDIVIDUAL.
(a) DEFINITION.—
(1) IN GENERAL.—For purposes of this division, the term ‘‘affordable credit eligible individual’’ means, subject to subsection (b), an individual who is lawfully present in a State in the United States (other than as a nonimmigrant described in a subparagraph (excluding subparagraphs (K), (T), (U), and (V)) of section 101(a)(15) of the Immigration and Nationality Act)— 20
(A) who is enrolled under an Exchange-participating health benefits plan and is not enrolled under such plan as an employee (or dependent of an employee) through an employer

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qualified health benefits plan that meets the requirements of section 312;

(B) with family income below 400% of the Federal poverty level for a family of the size involved; and
(C) who is not a Medicaid eligible individual, other than an individual described in section 202(d)(3) or an individual during a transition period under section 202(d)(4)(B)(ii).
(2) TREATMENT OF FAMILY.—Except as the Commissioner may otherwise provide, members of the same family who are affordable credit eligible individuals shall be treated as a single affordable credit individual eligible for the applicable credit for such a family under this subtitle.
(b) LIMITATIONS ON EMPLOYEE AND DEPENDENT DISQUALIFICATION.—
(1) IN GENERAL.—Subject to paragraph (2), the term ‘‘affordable credit eligible individual’’ does not include a full-time employee of an employer if the employer offers the employee coverage (for the employee and dependents) as a full-time employee under a group health plan if the coverage and employer contribution under the plan meet the requirements of section 312.

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(2) EXCEPTIONS.—
(A) FOR CERTAIN FAMILY CIRCUMSTANCES.—The Commissioner shall establish such exceptions and special rules in the case described in paragraph (1) as may be appropriate in the case of a divorced or separated individual or such a dependent of an employee who would otherwise be an affordable credit eligible individual.
(B) FOR UNAFFORDABLE EMPLOYER COVERAGE.—Beginning in Y2, in the case of full-time employees for which the cost of the employee premium for coverage under a group health plan would exceed 11% of current family income (determined by the Commissioner on the basis of verifiable documentation and without regard to section 245), paragraph (1)shall not apply.
(c) INCOME DEFINED.—
(1) IN GENERAL.—In this title, the term ‘‘income’’ means modified adjusted gross income (as defined in section 59B of the Internal Revenue Code of 1986).
(2) STUDY OF INCOME DISREGARDS.—The Commissioner shall conduct a study that examines

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the application of income disregards for purposes of this subtitle. Not later than the first day of Y2, the Commissioner shall submit to Congress a report on such study and shall include such recommendations as the Commissioner determines appropriate.
(d) CLARIFICATION OF TREATMENT OF AFFORDABILITY CREDITS.—Affordabilty credits under this subtitle shall not be treated, for purposes of title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, to be a benefit provided under section 403 of such title.

SEC. 243. AFFORDABLE PREMIUM CREDIT.
(a) IN GENERAL.—The affordability premium credit under this section for an affordable credit eligible individual enrolled in an Exchange-participating health benefits plan is in an amount equal to the amount (if any) by which the premium for the plan (or, if less, the reference premium amount specified in subsection (c)), exceeds the affordable premium amount specified in subsection (b) for the individual.
(b) AFFORDABLE PREMIUM AMOUNT.—
(1) IN GENERAL.—The affordable premium amount specified in this subsection for an individual for monthly premium in a plan year shall be equal to 1/12 of the product of—

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(A) the premium percentage limit specified in paragraph (2) for the individual based upon the individual’s family income for the plan year; and 4B) the individual’s family income for such plan year.
(2) PREMIUM PERCENTAGE LIMITS BASED ON TABLE.—
The Commissioner shall establish premium percentage limits so that for individuals whose family income is within an income tier specified in the table in subsection (d) such percentage limits shall increase, on a sliding scale in a linear manner, from the initial premium percentage to the final premium percentage specified in such table for such income tier.
(c) REFERENCE PREMIUM AMOUNT.—The reference premium amount specified in this subsection for a plan year for an individual in a premium rating area is equal to the average premium for the 3 basic plans in the area for the plan year with the lowest premium levels. In computing such amount the Commissioner may exclude plans with extremely limited enrollments.
(d) TABLE OF PREMIUM PERCENTAGE LIMITS AND ACTUARIAL VALUE PERCENTAGES BASED ON INCOME TIER.—

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(1) IN GENERAL.—For purposes of this subtitle, the table specified in this subsection is as follows:
In the case of family income (expressed as a percent of FPL) within the following income tier:

The initial premium percentage is— (1st column)
The final premium percentage is— (2nd column)
The actuarial value percentage is— (3rd column)
133% through 150% 1.5% 3% 97%
150% through 200% 3% 5% 93%
200% through 250% 5% 7% 85%
250% through 300% 7% 9% 78%
300% through 350% 9% 10% 72%
350% through 400% 10% 11% 70%

(2) SPECIAL RULES.—For purposes of applying the table under paragraph (1)—
(A) FOR LOWEST LEVEL OF INCOME.—In the case of an individual with income that does not exceed 133% of FPL, the individual shall be considered to have income that is 133 9% of FPL.
(B) APPLICATION OF HIGHER ACTUARIAL VALUE PERCENTAGE AT TIER TRANSITION POINTS.—If two actuarial value percentages may be determined with respect to an individual, the actuarial value percentage shall be the higher of such percentages.
SEC. 244. AFFORDABILITY COST-SHARING CREDIT.
(a) IN GENERAL.—The affordability cost-sharing credit under this section for an affordable credit eligible individual enrolled in an Exchange-participating health

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benefits plan is in the form of the cost-sharing reduction described in subsection (b) provided under this section for the income tier in which the individual is classified based on the individual’s family income.
(b) COST-SHARING REDUCTIONS.—The Commissioner shall specify a reduction in cost-sharing amounts and the annual limitation on cost-sharing specified in section 122(c)(2)(B) under a basic plan for each income tier specified in the table under section 243(d), with respect to a year, in a manner so that, as estimated by the Commissioner, the actuarial value of the coverage with such reduced cost-sharing amounts (and the reduced annual cost-sharing limit) is equal to the actuarial value percentage (specified in the table under section 243(d) for the income tier involved) of the full actuarial value if there were no cost-sharing imposed under the plan.
(c) DETERMINATION AND PAYMENT OF COST-SHARING AFFORDABILITY CREDIT.—In the case of an affordable credit eligible individual in a tier enrolled in an Exchange-participating health benefits plan offered by a QHBP offering entity, the Commissioner shall provide for payment to the offering entity of an amount equivalent to the increased actuarial value of the benefits under the plan provided under section 203(c)(2)(B) resulting from the reduction in cost-sharing described in subsection (b).

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SEC. 245. INCOME DETERMINATIONS.
(a) IN GENERAL.—In applying this subtitle for an affordability credit for an individual for a plan year, the individual’s income shall be the income (as defined in section 242(c)) for the individual for the most recent taxable year (as determined in accordance with rules of the Commissioner). The Federal poverty level applied shall be such level in effect as of the date of the application.
(b) PROGRAM INTEGRITY; INCOME VERIFICATION PROCEDURES.—
(1) PROGRAM INTEGRITY.—The Commissioner shall take such steps as may be appropriate to ensure the accuracy of determinations and redeterminations under this subtitle.
(2) INCOME VERIFICATION.—
(A) IN GENERAL.—Upon an initial application of an individual for an affordability credit under this subtitle (or in applying section 242(b)) or upon an application for a change in the affordability credit based upon a significant change in family income described in subparagraph (A)—
(i) the Commissioner shall request from the Secretary of the Treasury the disclosure to the Commissioner of such information as may be permitted to verify the

reimbursement to hospitals for those screenings and stabilizations are covered in section 1011 of the Medicare Prescription Drug, Improvement, and Modernization Act. There is a bill HR 1386 in the House Energy and Commerce Committee that would amend section 1011 to make it permanent. Marsha Blackburn is on that committee and I wonder how she feels about it.

Cost information for these reimbursements and illegal immigrants in general, from the National Conference of State Legislatures primer on Section 1011:

Section 1011 of the MMA authorized $250 million per year for FYs 2005-2008 for those payments. Two-thirds of the funds are divided among all 50 states and the District of Columbia, based on their relative percentages of unauthorized immigrants.

The other third is divided among the six states with the largest number of apprehensions of unauthorized immigrants. In 2007, the largest allocations went to California, which received $68.5 million; Texas, $47 million; Arizona, $44.5 million; New York, $12 million; Illinois, $10.3 million; Florida, $8.7 million; and New Mexico, $6.7 million.

A 2006 RAND study found that about $1.1 billion in federal, state and local government funds are spent annually on health care for undocumented immigrants aged 18 to 64. That amounts to an average $11 in taxes for each U.S. household. In contrast a total of $88 billion in government funds were spent on health care for all non-elderly adults in 2000.

“Our findings show a relatively small amount of tax money is spent on health services provided to undocumented immigrants,” said James Smith, an author of the report. “Costs will be much higher for educating the children of undocumented immigrants, so that’s where debate should center, not on these relatively small health-care costs.”

“The lower use of medical services by immigrants is driven in part by their lower rates of insurance,” added study co-author Dana Goldman. “But the largest factor appears to be due to their being generally healthier than the native-born population.”