Blue states put the brakes on medical care for illegal immigrants

“I’m frustrated because it’s not based on any policy decisions other than the dollar,” said Gillian Gilcrest, a Democrat who is spearheading a bill to extend Medicaid to all undocumented children this year. said the congressman. “The budget document outlines our priorities as a state.

Intraparty debate grapples with how the Biden administration and Democrats at the national level can expand access to health care for noncitizens — just 6% of the U.S. population but 23% of the uninsured — amid a split Congress. started inside.

Hopes for a public health insurance option, a hallmark of Biden’s presidential campaign, were dashed in the ensuing debate. Inflation control lawHouse Republicans passed instead Legislation adding work requirements Transitioning to Medicaid — Another 600,000 Americans could remain uninsured, according to the Congressional Budget Office.

Against this federal backdrop, progressive legislators are pushing policies for illegal immigration that, until recently, were outside mainstream Democratic thinking, and investing their own money to advance progress toward universal health care. and is trying to take over that role.

“The idea that health care should be accessible to everyone has changed over the last decade or so,” said Kelly Whitner, an associate professor in the Center for Children and Families at Georgetown University’s McCourt School of Public Policy. “How to get there is the tricky part, and I think the cost barrier is real.”

In Nevada, Democrats cut a $300 million proposal to extend Medicaid to all illegal immigrants to a $90 million policy for people up to age 26, with further cuts under consideration. Even if legislators were able to agree on the price tag, Republican Gov. Joe Lombardo has not said if he will sign it into law.

In Minnesota, where Democrats control the governor’s mansion and both houses of Congress for the first time in a decade, lawmakers will either extend coverage of state-funded Medicaid to illegal children, or It is debating whether to spend an additional $39 million to cover all illegal immigrants in the United States. Balancing many other priorities, such as K-12 schools, affordable housing, and childcare.

And in Connecticut, in 2021, lawmakers will extend Medicaid coverage for undocumented children to age 8. Last year, the program was expanded to include 12-year-olds. This year, a bill was submitted to allow up to 26 years of age, but the state’s burden is about 26 years old. $15 million a year, reduced to 15 at a cost of $3 million.

Immigration advocates, unhappy with the state’s tiered approach to expanding coverage, introduced additional legislation in the final week of Congress, arguing it could cover all children through age 18. Demanding $5 million. Connecticut Gov. Ned Lamont, a Democrat, said at a forum Wednesday that he was happy to extend the program to age 15.

“Hmm, advocates say, ‘Not enough,'” said Lamont. “Okay. That’s their job, but I think we’re making progress every day.”

Democrats who favor incremental coverage say they are methodical and resentful of accusations that it shows a lack of political will.

“That’s total nonsense,” said Democratic Sen. Kathy Osten of Connecticut, who co-chairs the Congressional Appropriations Committee. “We just want the program to deploy correctly.”

Illinois is warning those concerned about costs. According to the Department of Health and Family Services, the number of undocumented adults enrolled in Medicaid based on state expansions has surpassed actuarial firm Milliman’s projections. And from March 2022 to February 2023, the program nearly doubled Milliman’s projections, or $189 million more, to eligible adults, according to the state’s latest public data. the ministry said.

“Historically, enrollment is slow and low, people don’t always know insurance is available, or they are reluctant to enroll if they know insurance is new and available. “There was an assumption that there could be,” Whitener said. “But it’s not playing out like that in every state.”

Besides Illinois, California, Maine, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Vermont, and Washington have all expanded Medicaid to illegal immigrant children. Some of these states also provide benefits to adults through Medicaid or state health insurance exchanges. Undocumented immigrants and those who have been legally in the United States for less than five years are not eligible for Federal Medicaid.

And Utah’s Republican legislature passed a bill earlier this year to expand health coverage for undocumented children through the Children’s Health Insurance Program, amended to include a $4.5 million cap, data review requirements and a sunset clause. Republican Rep. Jim Dunnigan, who helped repeal the bill last year, co-sponsored the bill this spring after extensive talks with its proponents, the Democrats, seeking passage in the House. He led the way and said it passed 64-7. Supported by 52 Republicans.

“Some of my more conservative colleagues have said, ‘We have a heart if we make it right.’ We have hearts for our children,” said Dunigan. “Frankly, I was surprised by some of them. They were happy to listen, and I give them credit.”

Proponents of this policy argue that while undocumented coverage expansion will require significant and ongoing funding, dollars are only a small fraction of state budgets and preventive care is not available to people. It claims that keeping people out of emergency rooms will save money in the long run. free care costs. They also argue that the move will bring equality to families in mixed situations who are eligible for health care and those who are not, and that immigrants will pay taxes to fund these types of programs. are doing.

But in addition to worrying about costs, some lawmakers fear that expanded insurance coverage could lead to an influx of illegal immigrants from surrounding states. They move mainly for better housing, family reasons, and work. They also argue that if the program expands too quickly, it could strain the state’s medical infrastructure and create problems that could prevent people from receiving coverage.

In Maryland, Democratic leaders earlier this year rejected a bill that would allow illegal immigrants to purchase plans through the state’s health insurance exchange, saying more research was needed on the issue.

“What you have is a group of people who have identified a solution to some of the problems. I don’t think you understand what we want to see, Maryland Senate Finance Committee chair and Democrat Melonie Griffiths told reporters last month, “We are the most vulnerable people.” We want to make sure we meet the needs of the state and make the most of the investment the state has made.”

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