Sunday, September 06, 2009

What Is Wrong With You People?

"I don't know what could be more clear," said Representative Bruce Braley, Democrat of Iowa, who has read aloud from a section of the House bill with the title "No Federal Payments for Undocumented Aliens."

"Heath Care Debate Revives Immigration Battle,"
New York Times, 6 Sep 2009

From House Bill 3200, page 143:
SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED
4 ALIENS.
5 Nothing in this subtitle shall allow Federal payments
6 for affordability credits on behalf of individuals who are
7 not lawfully present in the United States.

* * *


Taxpayers are concerned whether they will have to foot the bill for illegal aliens in the upcoming health care bill. Many ask good questions, like how will health care workers know who's an illegal alien? If they are included, how will it be paid for? These are important questions that we would hope could be dealt with squarely, openly and with full transparency.

But this is a sensitive topic for Congressmen interested in securing reelection.

During the summer recess, many Congressmen were barraged by questions to this effect. So it was interesting reading this New York Times piece this morning on whether illegal aliens will be covered under the new health care plan before Congress. On one hand we have Congressmen placating his constituents by assuring voters that "I don't know how it could be more clear" as they suggest taxpayers will not fund illegal aliens, but careful inspection discloses that illegal aliens will just not be eligible for federal subsidies to reduce their payments for federally-supplied health insurance.

But from here, it gets even more byzantine:
... the report finds that the House bill would not prohibit illegal immigrants from enrolling in a health insurance exchange. The exchange would allow participants to buy coverage from one of several plans, including a public option offered by the federal government.

At the same time, illegal immigrants would not be exempt from the obligations in the House bill. According to the research service, most illegal immigrants in the country would be required to buy health insurance or face tax penalties.

And since they would be barred from subsidies, they would have to pay for coverage at full rates, regardless of their income level.
So here we have illegal aliens, already strapped for cash, paying their "full payment" and if they don't, the tax man will come after them (which is confusing to me, because I didn't know that illegal aliens pay taxes).

So what is wrong with the public? How could they possibly be confused?

Here's a thought: the only real way out of these shameful machinations is to deal with the immigration and health care issue separately, incrementally, and without this shell game. Doesn't the American public deserve a more thorough discussion of this issue, rather than shoving it in to our upcoming health care legislation?

My personal sense of it is that such an issue will never be decided at the Emergency Room door. Rather, it is part of a systemic immigration control and reform question that involves our borders, employee verification, and a decision about existing illegal immigrants.

What we're observing instead, is a Congress is too scared to deal with this issue honestly.

-Wes

5 comments:

shadowfax said...

Most illegals pay far more than their "real" tax rate. They get jobs with an W-4 and a bogus SSN, and the employer dutifully withholds taxes. As low-income (usually) workers, they would generally be eligible for a full refund (and probably an EITC) were they to file a 1040EZ, but they don't because they are, you know, illegal.

It's actually a catch-22 for the IRS as well, because they are collecting all this money which they are not allowed to account as revenue, but will never be paid out in refunds, so it sits forever in escrow-type accounts.

So anyway, yes, the illegals do pay taxes. But since they don't file tax returns, the penalties for not having insurance won't be imposed on the refunds they never receive.

Bottom line: HR 3200 probably won't impact the immigration situation much. Theoretically, well-paid illegals might be able to get individual policies through the NIE, but let's be honest, there are not too many well-off illegals who'll be able to afford that (and possess the sophistication to navigate the system with their bogus SSNs).

Ultimately you are quite right that employer verification is the solution that will have to be imposed sooner or later.

DrWes said...

shadowfax -

It's actually a catch-22 for the IRS as well, because they are collecting all this money which they are not allowed to account as revenue, but will never be paid out in refunds, so it sits forever in escrow-type accounts. So anyway, yes, the illegals do pay taxes. But since they don't file tax returns, the penalties for not having insurance won't be imposed on the refunds they never receive.

And so, while the bill specifically states that illegal aliens will not receive government subsidies, they will, in fact, be able to subscribe to "one of several plans, including a public option."

Is the public plan not a government-subsidized insurance program?

Just asking.

shadowfax said...

Is the public plan not a government-subsidized insurance program?

Sigh. This is the problem with this whole debate. The public option, in some people's minds, is synonymous with "subsidized."

So, no, no it is not. Not as described in either the Senate HELP bill or HR 3200. It is self-sufficient and funded through premiums.

Now some patients can be subsidized, and if they qualify for a subsidy they could choose the public option, or any private option in the NIE. But undocumented aliens won't be able to get subsidies, because to get the subsidies you will need to a) have a valid SSN and b) have to file taxes, which illegals don't do.

Bottom line, under the health reform as proposed, it's looking very likely like the undocumented will remain uninsured and I will continue to care for them for free.

BTW, some people refuse to accept that the public option is unsubsidized, with varying explanations: The startup capital will be a government-backed loan, the shared administration with other HHS programs, or the belief that the program will eventually be subsidized directly. The first is not a subsidy, just a cheaper cost of capital. The second is an efficiency and a good reason to do it. The third is, at this point, pure fantasy.

At this point, the public option, should it be enacted as described, is just a competitor in the NIE, not an entitlement, not a drain on the general funds, and not subsidized.

DrWes said...

shadowfax-

Bottom line, under the health reform as proposed, it's looking very likely like the undocumented will remain uninsured and I will continue to care for them for free.

So when illegals buy into the system will they be insured or uninsured?

Oh my! I'm so confused!!

(Shadow, our ability to understand this is exactly the point.)

Andrew_M_Garland said...

There can be no reasonable debate on healthcare because the Obama Team and the Democrat part of Congress has not released a readable document spelling out the policy that they want to implement.

The government demands detailed, researched Environmental Impact Statements before starting a building. We should have Official Policy Impact Statements before our representatives change our society.

We need proposed results, expected evolution, methods, justifications, comparative studies, past successes of similar policy, funding sources, expected difficulties, the works.

Would Obama try to legislate from some scribbles on a cocktail napkin? Would he think "give me anything, we'll rearrange it later to do what we want"?

Join me in the demand to "Show me the policy paper!" If any politician refuses or says that it doesn't exist, then mock him with "Show me the cocktail napkin!"

A Few Words About Policy