I guess it comes down to a case of you win some, you lose some. While it remains true that the formal language of key health reform proposals doesn't authorize health insurance coverage for illegal immigrants, rules that would make it tough for them to get insurance would also screen out significant numbers of eligible Americans, according to an analysis by the Congressional Budget Office.
The CBO, which was responding to a request for information from Sen. Chuck Grassley (R-IA), examined the impact of the current health reform bill under revision in the Senate Finance Committee and the related House bill, the America's Affordable Health Choices Act of 2009.
As things stand, the current nonelderly unauthorized immigration population will total about 14 million in 2019, the CBO projects. It assumes that almost 60 percent of that group will be uninsured, 25 percent will have work-related coverage, 7 percent will have coverage other than Medicaid, and 10 percent will have limited Medicaid coverage available under laws authorizing such coverage for emergency care.
The letter notes that states will probably be good at screening out ineligible immigrants from getting Medicaid, but that it could prove a costly process to make sure they're not included in health insurance exchanges or getting refundable tax credits for coverage. It also notes that while blocking illegal immigrants from entering the program might save on medical care, the savings would be offset by administrative expenses.
What's missing from the CBO's analysis are numerical estimates as to just how many unauthorized immigrants would slip through the screening process for broad-based health coverage. In essence, the CBO hasn't really answered the questions Grassley and other critics have raised as to just how big a problem coverage for the undocumented immigrants might be. This may be good politics--it's sort of a nobody-wins issue--but not terribly useful either.
To learn more about the CBO's estimate:
- read this letter to Chuck Grassley (.pdf)