Health care debate hits glitch with immigration

MONTPELIER — Following public outcry, a conference committee working to reconcile the House and Senate versions of the recent health care bill on Tuesday announced it had removed language that would bar illegal immigrants from health coverage.
Sen. Claire Ayer, D-Weybridge, a member of the conference committee, said the removal of the amendment doesn’t necessarily mean that Vermont will be able to insure non-legal residents under the Green Mountain Care plan, which the law would establish. But new language in the bill urges the federal government to pursue immigration policy reform, and it commissions a study to explore the costs of providing care to illegal workers in the state.
“(Federal law) prohibits us from using federal money to cover illegal immigrants, and yet it says that our hospitals must accept and treat them for free,” Ayer said. “That’s a cost shift.”
The Brock-Sears amendment to the health reform bill considered by the Vermont Senate would have stipulated that Vermont could not spend federal dollars on health care for non-legal residents, essentially barring them from coverage under a state single-payer plan.
In an interview on Fox News, Sen. Randy Brock, R-Franklin, explained, “We wouldn’t provide membership to someone from Iowa who was here temporarily, so why would we do so for someone here illegally who, by definition, is here temporarily?”
Ayer said that many senators approved the last-minute Brock-Sears amendment because they assumed the language specifically pertaining to federal spending and immigration status had to be in the bill. And some legislators supported the language because the echoing of language used in the federal health care bill could make it easier for the state to gain support and funding on a federal level for Green Mountain Care.
The state-administered health care exchanges created by last year’s federal health reform law would have to bar illegal immigrants from participating, as language states that federal funding cannot go to nonresidents of the country. But Ayer said there is little known about what restrictions will be placed on states like Vermont, which, if the health care reform bill is passed, would be on track to move beyond the exchange to a single payer system by 2017.
If regulations do end up requiring Vermont to exclude illegal immigrants from the single-payer plan in order to get federal money, said Ayer, the state will have to follow.
“We need to make sure we’re mindful of federal law,” she said. “We’re planning on quite a lot of federal money, so we need to be in compliance.”
But since the specific requirements that will come down from the federal level are not yet clear, the committee chose not to include any requirements pertaining to legal residency.
For now migrant worker and labor rights groups are celebrating the removal of the Brock-Sears amendment.
“What we saw with this last-minute amendment was an attempt to exclude people,” said James Haslam, director of the Vermont Workers’ Center, which leads the “Healthcare Is a Human Right” campaign.
On Sunday, the Healthcare Is a Human Right campaign brought more than 2,000 people to the streets of Montpelier in support of the state’s universal health care plan, and another 40 people headed to the statehouse on Monday specifically to protest the amendment.
Haslam said a bill that creates an exclusionary single-payer system right off the bat goes against the first goal of a universal health care plan — that is, universality. Further, he said that many undocumented workers in the state already have payroll taxes deducted for Social Security, Medicare and Medicaid without ever reaping benefits from those programs. He added that there is nothing in state law that says a person must be a U.S. citizen in order to be a Vermont resident.
“(Migrant farm workers) are productive parts of our communities,” said Haslam. “They work hard. The real problem is that our immigration laws are broken.”
Ayer agreed. Under the visa system that exists today, she said, immigrants can come to Addison County to work as apple pickers and turkey pluckers seasonally, and employers must provide health insurance. But since dairy workers are not seasonal, some stay in the county beyond the legal limit, are not covered by health insurance and use the services of the emergency room for any medical issues.
She said the Green Mountain Care board, as part of its report on the costs of providing care to illegal workers, will examine the costs of delayed care for illegal workers who don’t have the resources to seek preventative care, and the potential costs of insuring them.
The details of the plan will not be worked out for several years, but Ayer said that by then, she hopes to see some kind of federal program that allows dairy workers to get visas to enter the country.
“The question is, why don’t we try to come up with a saner immigration policy?” she said.
Ultimately, said Ayer, covering farm workers under Green Mountain Care would likely not be very expensive as most are relatively young and healthy.
“It would be a sensible thing for an ag state to do, to allow ag workers to buy into the policy,” she said.
Reporter Andrea Suozzo is at [email protected].

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