FAIR

Latest House Health Care Bill Contains Verification Process that Raises Concerns

Last Thursday, Speaker Nancy Pelosi (D-CA) introduced the latest version of the House health care bill, The Affordable Health Care for America Act (H.R. 3962). FAIR had raised concerns about a previous version of this bill (H.R. 3200) due to its lack of a verification mechanism to ensure that illegal aliens would be unable to obtain taxpayer-funded health care benefits under the bill. (See FAIR’s Legislative Analysis, July 31, 2009).

Section 342(d)(4) of the latest House health care bill does contain a verification mechanism, but that mechanism falls short of the kind of verification that FAIR has said would be necessary to protect the American taxpayers. Prior to this year, Congress had required that individuals claiming to be citizens must first present, and States must review, citizenship documentation before being allowed to enroll in a State administered program that provides certain federal benefits, such as the Medicaid program. (Non-citizen eligibility would be determined under a parallel system using the Systematic Alien Verification for Entitlements (“SAVE”) system). The documentation requirements for citizens had been spelled out by the Center for Medicare and Medicaid Services (CMS) in a memo as recently as June 9, 2006 and included a requirement that people provide documentation supporting their claim of citizenship. (See CMS Letter, June 9, 2009 and accompanying regulations, July 12, 2006).

With the passage of the Children’s Health Insurance Program (“CHIP”) Reauthorization Act of 2009 earlier this year (Public Law 111-3), however, Congress created an alternative system that simply allowed anyone who claimed to be a citizen, and who was otherwise income-eligible, to enroll in certain federal health care programs (like CHIP and Medicaid) as long as that individual provided a name and Social Security number (SSN) that matched. (See Section 211 of the CHIP bill, codified as Section 1902(ee) of the Social Security Act). This provision actually weakened the existing documentation requirements, as applicants would no longer have to bring any identification, such as a photo I.D., as part of the enrollment process to demonstrate that they actually are who they say they are. (This change runs counter to many other important and effective immigration enforcement programs, like E-Verify. E-Verify requires employers to have a completed I-9 form prior to running an E-Verify check. See USCIS’ E-Verify Quick Reference Guide, The I-9 form, in turn, requires the new hire to present a government issued photo I.D.). In addition, the CHIP bill also allows individuals to enroll in the government program even before any eligibility determination, i.e., the name-SSN match, had been made.

What exactly does this mean? During debate over the CHIP bill, Senator Jon Kyl (R-AZ) had the following to say with respect to Section 211 of the CHIP bill:

“The problematic section is Section 211. This will likely increase the number of illegal immigrants… because it eliminates the current document verification to demonstrate that you are entitled to accept the benefits of the program…. In my State, all of the illegal immigrants–virtually all of the illegal immigrants have Social Security numbers. In fact, they have a lot of Social Security numbers…. So even if they are checked through the system, which this bill does not require, you would [not] catch them. All you have to do is to say: Here is a Social Security number. Now let me avail myself of the benefits.”

(Congressional Record, January 26, 2009, S802).

So, despite the inclusion of a verification system in the latest health care bill, this verification process will not work to effectively preclude illegal aliens from accessing the taxpayer-funded affordability credit. For example, the CHIP bill provides that this section, Section 211, will not even go into effect until January 1, 2010. Accordingly, the cornerstone of the eligibility verification system in the latest version of the House health care bill: (1) does not yet exist; (2) has not yet been proven to work; and (3) has not been assessed for effectiveness (by the Government Accountability Office (GAO) or any other agency). This is troubling, to say the least.

There is, however, an easy fix that can be made to the House bill to make the verification system workable. The bill should go back to previous law and require an applicant for the affordability credit to present some form of government issued identification to demonstrate that: (1) they are who they say they are; and(2) if they claim to be a citizen, that they can demonstrate that fact. These goals could easily be accomplished. For example, an amendment that strikes the reference in the bill to Section 1902(ee) of the Social Security Act (on page 230, line 4) and substitutes Section 1903(x) of the Social Security Act, which lists a variety of different forms of identification to adequately demonstrate an individual is a citizen of the United States, would achieve this goal. (See Section 1903(x)).

Stay tuned to FAIR’s Legislative Update for more information as the debate over the health care bill and immigration continue to unfold.

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