Illegal Immigrants Still an Issue in Senate Health Care Negotiations

Despite the Obama administration's assurances that illegal immigrants will not receive health insurance benefits under health care reform, six key senators dealt with the increasingly contentious issue as they worked behind closed doors Monday.

The 'gang of six' senators-- three Democrats and three Republicans-- are in the final stages of fashioning a compromise on health care that could get the 60 votes necessary to pass out of the chamber. Sen. Max Baucus (D-Mont.), the chairman of the Senate Finance Committee, said Monday that the group had discussed several specific items in negotiations, including the treatment of illegal immigrants. "We want to make sure that (illegal) immigrants are not part of the exchange and get no benefits here," Baucus said.

Although the House version of the bill specifically excludes illegal immigrants from receiving federally-funded health benefits under the "Affordable Health Choices Act," several Republicans, including Rep. Joe Wilson (R-S.C.) have complained that the bill lacks a mechanism to verify an applicant's immigration status before being included in the program. The House bill also does not explicitly prevent undocumented workers from spending their own money to enroll in a health care exchange.

Wilson's now-famous outburst came during President Obama's address to a joint session of Congress when Obama said, "The reforms I am proposing would not apply to those who are here illegally." When Wilson yelled, "You lie!" Obama responded to Wilson, "That's not true."

The next day, however, the White House put out a clarification to several news organizations saying that proof of legal residency will be required for anyone enrolling in an exchange under health care reform under the President's guidelines.

Sen. Kent Conrad (D-N.D.), the chairman of the Budget Committee and another negotiator, also said that illegal immigrants had been a focus of the senators' discussions. He said the group worked on "further refinements on how we make certain that no one who is here illegally would benefit from these additions."

Conrad added that the senators had made "very substantial progress" on several other issues, including medical malpractice reform, preventing federal funding for abortion and cost-sharing with states on Medicaid. Both Conrad and Baucus said that the Congressional Budget Office had scored the Finance Committee's trimmed-down health care reform bill as deficit-neutral and costing less than $880 billion over ten years, far less than the House's $1.3 trillion version.

In terms of timing, Baucus said he is "on track" to release the Finance Committee's bill this week and schedule a committee vote next week. He added that all three Republican senators, Mike Enzi (Wyo.), Olympia Snowe (Maine), and Charles Grassley (Iowa) are still actively negotiating with Democrats. "We're all talking. We're all meeting," Baucus said. "We're all trying to figure out what we can do."

Ultimately, Baucus predicted that he will win so-far elusive Republican support for the measure. "I think basically as senators on and off the committee and the public get to know more about all of this, the comfort level will start to come up. I believe that in the end we will have significant bipartisan support."

Details of the Senate bill, including provisions dealing with illegal immigrants, are expected as early as Wednesday. But no matter what the bill ultimately says on insurance coverage, Secretary of Health and Human Services Kathleen Sebelius told Politics Daily last week that anyone seeking treatment in emergency rooms will continue to receive care regardless of immigration status or ability to pay. "It has been a tradition in this country that we don't turn away somebody who is ill or dying potentially," she said. "That will remain the federal law unless Congress changes it."