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Because of the lack of immigration verification requirements in the House health care bill, an estimated 6.6 million illegal aliens could be covered because they meet the financial criteria. Those 6.6 million currently cost the public $4.3 billion in emergency rooms and free health clinics but would cost $31 billion under the House health care system.

The study was released today (Sep. 8, 2009) by the Center for Immigration Studies.

The non-partisan independent research institution noted that it takes no position on the efforts at health reform in general or on the overall House legislative proposals.

The CIS study focused entirely on the question of coverage of people in the United States who are not citizens or lawful permanent residents.

While the bill states that illegal immigrants are not eligible for the new taxpayer-funded affordability credits, there is nothing in the bill to enforce this provision. Congress defeated efforts to require the use of the Systematic Alien Verification for Entitlements (SAVE) program.

-- Center for Immigration Studies

Particularly important to note is that more than 70 other programs of the same nature as the proposed health care initiative use SAVE to verify legal presence and eligibility. The House leadership's insistence that verification would be onerous makes no sense, given that the same verification is used so widely throughout federal, state and local governments.

The study is especially important in answering the question of whether taxpayers aren't already footing a gigantic bill for health care for illegal aliens and whether including them in a federal system might be cheaper.

According to the study, illegal aliens are burdening taxpayers with $4.3 billion of costs right now. And that is plenty high to cause a number of hospitals in border states to collapse or struggle near bankruptcy.

Nonetheless, most illegal aliens dramatically under use health care, compared with legal residents, the study states. But if they were covered by health insurance, they would likely cost the federal system the same as legal residents, adding up to more than $30 billion a year -- a $26-billion potential increase in public costs for illegal aliens.

Here are the key findings from the new CIS study:

  • In 2007, there were an estimated 6.6 million illegal immigrants without health insurance who had incomes below 400 percent of poverty, which is the income ceiling for the new affordability premium credits.
  • If all uninsured illegal immigrants with incomes below 400 percent of poverty received the new credits, the estimated cost to the federal government would be $30.5 billion annually.
  • The current cost of treating uninsured illegal immigrants at all levels of government is an estimated $4.3 billion a year, primarily at emergency rooms and free clinics.
  • On July 16 an amendment by Rep. Dean Heller (R-NV) that would have required the use of the Systematic Alien Verification for Entitlements (SAVE) program to prevent illegal immigrants from receiving the affordability credits was defeated by the House Ways and Means Committee.
  • At present 71 other means-tested federal programs require use of the SAVE system to prevent illegal immigrants and other ineligible non-citizens from accessing them.
  • Even though there is no mechanism to prevent enrollment, it is likely that many income-eligible illegal immigrants would not enroll out of fear or lack of knowledge of the new programs. Thus the actual costs would be less than the maximum estimate of $30.5 billion. However, if illegal immigrants are legalized and could receive affordability credits, a much larger percentage would be expected to enroll, with a corresponding increase in costs.
  • Uninsured illegal immigrants tend to use less in health care on average than others without health insurance because they tend to be young. This fact is incorporated into the current cost estimate of $4.3 billion. However, government-provided affordability credits paid to insurance companies are the same for everyone regardless of age or preexisting conditions. Therefore, the younger age of illegals does not result in lower average costs for taxpayers for this program.
  • It is also worth noting that the report estimates that 38 percent of illegal immigrants had health insurance in 2007. Additionally, the report estimates that there are at least 360,000 uninsured illegal immigrants with incomes above 400 percent of poverty who would not qualify for benefits under H.R. 3200.
  • It is also possible that illegal immigrants could benefit from the expansion of Medicaid under H.R. 3200. The bill does not require identity verification for those claiming U.S. birth. Of illegal immigrants with incomes under 400 percent of poverty, about half live under 133 percent of poverty, which is the new ceiling for Medicaid eligibility.
  • On July 30 an amendment by Rep. Nathan Deal (R-GA) that would have required identity variation for those claiming U.S. birth was defeated by the House Energy and Commerce Committee.

The Center for Immigration Studies stated this as its methodology:

To estimate the number of illegal immigrants in the United States this report uses the March 2008 Current Population Survey (CPS) collected by the Census Bureau. While the CPS does not ask the foreign-born if they are legal residents, the Department of Homeland Security (DHS), former INS, and other outside researchers have all used socio-demographic characteristics in Census Bureau data to estimate the size of the illegal alien population; this report follows the same approach. The March CPS also asks about income and health insurance coverage and on this basis the report estimates the share of low-income illegal immigrants who are without health insurance coverage. By design these estimates of the size and characteristics of the illegal-immigrant population match those researchers.

 View the report at http://www.cis.org/IllegalsAndHealthCareHR3200

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