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Low-income immigrants look to Medicare bill to get health aid

Monday, June 23, 2003

WASHINGTON -- The longtime drive to restore government aid to legal immigrants is taking a shaky step forward with a Medicare bill now moving through Congress.

The proposal, added by senators, could mean victory for advocates after years of effort. Or it might be another in a series of false starts for those pushing since 1996 to bring legal immigrants back into aid programs.

Chances for the plan, which would aid hundreds of thousands of pregnant women and children, dimmed after the White House came out against it. But advocates hold out hope they eventually will prevail -- if not now, then when the welfare law is renewed this year.

Illegal immigrants never have been eligible for government aid. In 1996, during the eagerness to rewrite the welfare laws, Congress cut off nearly all legal immigrants from cash assistance, Medicaid, food stamps and disability payments.

President Clinton signed the bill but promised to try and reverse the immigrant provisions. The fight has persisted since.

Backers of the ban note that people coming to the United States must have sponsors who agree to support them if they fall on hard times.

"We don't want to have our generosity of welfare as a magnet encouraging people to come into the country," said Sen. Don Nickles, R-Okla. He tried to remove from the Medicare bill the provision to restore health benefits when the legislation was before the Senate Finance Committee. His amendment lost on a 13-8 vote, and the provision was added to the overall bill last week.

All Democrats, plus three Republicans, voted to keep it in.

"Everyone who is legally residing in this country ought to have the same opportunity for benefits," said Senate Democratic leader Tom Daschle of South Dakota.

The issue is important to groups representing Hispanics, now the largest minority group in the United States, and to states, which must pay the full cost if they want to continue helping noncitizens.

"The federal government is shirking its responsibility," declared then-Gov. George W. Bush of Texas in 1997, as his state was restoring some food stamp aid. "Texans are compassionate people, who will help those who truly cannot help themselves."

Bush went on to win the White House, partly by reaching out aggressively to Hispanic voters. Advocates for immigrants hoped he would take their side on the benefit issue when he got to Washington.

Bush has gone part of the way.

Immigrants initially were banned from food stamps. In 1998, Congress restored eligibility for those who were in the country in August 1996, when the welfare bill became law.

Last year, Bush supported and then signed legislation opening food aid to immigrants in the country for at least five years, no matter when they arrived.

The rules are similar for cash welfare; Medicaid, which covers the very poor; and the State Children's Health Insurance Program, which covers children of the working poor. Federal money cannot be used to help anyone who arrived after 1996 and has been in the United States less than five years.

Nearly half the states use their own money to give these people health benefits, and they have lobbied heavily for Washington to resume paying its share.

Last year, the Senate Finance Committee moved to let pregnant women and children into Medicaid and children's insurance as part of welfare legislation. The bill never reached the full Senate.

Now the issue is before the Senate again, sooner than expected. The same provision was included in the Medicare bill. Its cost to the federal government over 10 years is estimated at about $2.2 billion, and it eventually would aid about 170,000 children and 110,000 pregnant women each year.

Beyond the substantive question about immigrants and welfare, Nickles objects to including this in the Medicare bill, saying the debate should take place in the welfare bill. "This was agreed to because people were in a dealmaking mood," he said.

The White House agreed. "These provisions contradict current welfare reform policy and should not be undone in Medicare reform legislation," the administration said in its assessment of the bill.

The statement suggested Congress give states the flexibility to include immigrants by enacting a larger Medicaid overhaul that would set states free of numerous federal rules.

Even should the full Senate go along, the provision still must get through the Republican House. Its GOP champion there, Rep. Lincoln Diaz-Balart of Florida, says he regularly has to defend the issue to his colleagues, who worry about the cost. But he predicted the drive ultimately will succeed.

"I'm a little bit frustrated that we haven't been able to do it so far," he said, "but I'm hopeful."


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