Immigrant Health Care Bill Dumped

Congressional Republicans have dropped legislation that would help pregnant legal immigrants and their children to regain health care benefits that were taken away as part of the 1996 welfare reform law, legislative aides said Monday.

In closed-door meetings late last week, GOP negotiators decided to jettison a version of the measure that would have given states the option of offering government-subsidized health care to legal immigrant children and pregnant women who have been in the country at least two years, according to Republican aides.

The legislation had been backed by a bipartisan group of lawmakers, including a number of Latino House members. Two of its leading backers were Rep. Lincoln Diaz-Balart (R-Fla.) and Rep. Henry A. Waxman (D-Los Angeles). Florida Gov. Jeb Bush as well as two Republican Senate candidates, Reps. Rick Lazio (R-N.Y.) and Bill McCollum (R-Fla.), also supported the measure.

But several powerful Texas lawmakers, led by Texas GOP Reps. Bill Archer and Lamar S. Smith, said that such a change would be an unacceptable retreat from welfare reform.

“It is critically important to ensure that noncitizens come to America for opportunity and not for welfare,” wrote Smith and Archer in a letter to House Speaker J. Dennis Hastert (R-Ill.).

The issue highlights divisions between Republican lawmakers who want to reach out to Latinos and those who take a hard-line anti-immigrant stand. For now, at least, support appears stronger for the anti-immigrant position.

“There’s division on all kinds of things,” said Rep. Brian P. Bilbray (R-San Diego), an early supporter of the provision to restore benefits. “Perinatal service is so much more cost-effective than having a premature delivery. From a humanitarian point of view, it’s the right thing, [and] from a budgetary point of view, it’s the right thing to do.”

Texas Gov. George W. Bush, the Republican presidential nominee, has not taken a position on the bill, his staff said. Texas has a large immigrant population, and Bush has sought to reach out to Latinos.

The GOP is similarly divided on whether to give amnesty to more than 300,000 Latinos who failed to apply when amnesty was available but have been living and working in the United States for many years.

The health care measure would have modified a provision of the 1996 welfare reform law that prohibited legal immigrants from enrolling for five years in the Medicaid program, which is jointly funded by the federal government and the states. Public health advocates as well as many lawmakers said that the change was needed to ensure the health of all children and communities.

If enacted, it would help about 130,000 children and 50,000 pregnant women over the next five years at a cost of about $500 million, according to the nonpartisan Congressional Budget Office. About 40% of those who would be helped are in California. The program would have sent about $45 million a year to the state.

The legislation had been added to the House version of a $26-billion bill intended to help Medicare HMOs and hospitals. That bill will come to a vote in the House and Senate by midweek.

This year’s fight over immigrants’ health benefits reprises one of the most bitter confrontations in the 1996 welfare reform debate: whether the goal of reform was only to end the entitlement to cash benefits for poor Americans or whether it also was intended to stop immigrants from using the health care system.

“If you look at the broad welfare reform debate, it was around entitlements and work and family structure and personal responsibility,” said Alan Weil, director of the New Federalism Project at the Urban Institute. “But the immigrant piece wasn’t an accident. It was a significant share of the savings associated with the bill and, for some lawmakers, it was a matter of principle.”

Until 1996, legal immigrants were accorded the same rights and responsibilities as native-born Americans or naturalized citizens. For instance, legal immigrants pay taxes and must register for the Selective Service system. In turn, they were eligible for Medicaid.

That changed under welfare reform. Legal immigrant children and pregnant women lost health care coverage unless they had been in the country for five years. In addition, the citizen children of legal immigrants lost coverage because many legal immigrants did not understand that their children were still eligible for Medicaid.

The effort to restore health care for children and pregnant women has strong support in the Latino community, where the percentage of people with health insurance is lower than for any other group.

“These are pregnant women and children, these are the most precious and vulnerable in our population,” said Marcela Urrutia of La Raza, a national organization that represents immigrant interests. “Pregnant women pay taxes too.”