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Health Care Subsidies for Illegal Immigrants Still a Problem for Democrats

November 06, 2009

ROLL CALL: Rep. Velazquez and the CHC will vote against the bill iflanguage restricting the rights of illegal immigrants to buy insurance is ADDED to the bill.”  (Emphasis added, but not restrictions on illegal immigrants getting taxpayer subsidies.)

THE HILL: “Congressional Hispanics have threatened to vote against the bill because of a last-minute threat from within the Democratic Caucus to bolster the House bill’s immigration restrictions.

POLITICO: The CHC “has 20 votes for the current immigration language and would oppose the verification requirements in the Senate bill.”

Hispanic Caucus Threatens to Block Health Bill Over Immigration Language
By Jennifer Bendery
Nov. 5, 2009, 6:42 p.m. 

Congressional Hispanic Caucus Chairwoman Nydia Velázquez (D-N.Y.) warned President Barack Obama on Thursday that 20 members of her caucus are prepared to vote against the House Democratic health care plan if language restricting the rights of illegal immigrants to buy insurance is added to the bill.

Velazquez met with Obama at the White House with a handful of other CHC members, including House Democratic Caucus Vice Chairman Xavier Becerra (D-Calif.) and Reps. Charlie Gonzalez (D-Texas) and Lucille Roybal-Allard (D-Calif.).

“He listened to us and he knows where we stand,” Velazquez said. “We made it very clear that we support the language that is in the House. We expect that the current language will not change.”

At issue is whether to adopt Senate language that would bar illegal immigrants from buying insurance with their own money through a new national insurance exchange. The White House and the Senate Finance Committee have backed such a ban, but House liberals and the CHC in particular are strongly opposed to the idea.

Velazquez said she didn’t know who is trying to have the language changed. Asked where Speaker Nancy Pelosi (D-Calif.) is on the matter, Velazquez said, “We will continue to have discussions.”

Rep. Chris Van Hollen (D-Md.) — charged with looking out for politically vulnerable Democrats as Assistant to the Speaker and Democratic Congressional Campaign Committee chairman — has pushed to move the House bill closer to the Senate’s hard line. He huddled with the CHC on Thursday to tell them he supports the bill as currently written but warns that differences between the chambers’ approaches will have to be reconciled at some point, a senior Democratic aide said. The aide described the session as cordial.

Rules Chairwoman Louise Slaughter (D-N.Y.) said that in recent discussions people seem happy with the immigration language already in the bill, which prohibits illegal immigrants from getting subsidies but allows them to buy insurance with their own money.

“As far as I know … everybody’s pretty content with the rule the way it is,” she said.
Slaughter and other Members were heading into a meeting Thursday evening to discuss changes to the abortion language in the bill in an effort to assuage the concerns of Democrats opposed to abortion rights.

Illegal immigration issue threatens healthcare vote
By Jared Allen – 11/05/09 07:38 PM ET
The illegal immigration issue is emerging as the biggest threat to passing healthcare reform in the House.

Congressional Hispanics have threatened to vote against the bill because of a last-minute threat from within the Democratic Caucus to bolster the House bill’s immigration restrictions to match those included in the Senate Finance bill.

And they’re also fighting President Barack Obama, the original sponsor of the language prohibiting illegal immigrants from accessing the public health insurance exchange.

On Thursday afternoon, four leaders of the Congressional Hispanic Caucus (CHC) traveled to the White House to meet with Obama on behalf of the entire group.

Officially, the purpose of their meeting was to talk to the president about healthcare.
But CHC members, speaking on the condition of anonymity, said the group’s message was clear: Drop your insistence on preventing illegal immigrants from accessing the public exchange, even if their only option is to pay for insurance plans entirely out of their own pockets.

A public exchange is a nationwide pool of health insurance providers that would facilitate access to coverage for individuals and employers.

Obama has promoted the concept as a key component of healthcare reform.

The House healthcare bill already bars illegal immigrants from enrolling in the public option and from receiving subsidies for health plans.

But if the final Senate healthcare bill contains the exchange-prohibition provision that’s in the Finance Committee bill, the provision could also be included in a conference report.

And CHC members have said publicly that they would have a very difficult time voting for any healthcare bill that contained such a provision.

 “I am concerned about the manner in which the exchange has been characterized, and I understand the politics of it,” said CHC Vice Chairman Rep. Charles Gonzalez (D-Texas), “but it is very bad policy.”

Gonzalez was at the White House meeting along with CHC Chairwoman Rep. Nydia Velázquez (D-N.Y.), Rep. Lucille Roybal-Allard (D-Calif.) and Democratic Caucus Vice Chairman Xavier Becerra (D-Calif.), the only Hispanic member of the Democratic leadership.

Vulnerable Democrats may push for language that would match the Senate provision on preventing illegal immigrants from accessing a public exchange.

And while there was no identifiable sponsor or group of members pushing for that last-minute change, a Democrat with direct knowledge of the process for guiding the healthcare bill through the Rules Committee described it as a distinct possibility.

 If House leaders determined that they needed to insert the Senate immigration language in order to pass the healthcare bill, the Senate language would be included in a “self-executing” rule allowing for consideration of the healthcare bill containing the change.

Should that occur, members of the CHC have said they will vote against the rule. Assuming all Republicans vote no, a revolt of any more than 37 Democrats would torpedo the legislation. The CHC has 27 members.

But a significant number of Democrats — largely from conservative districts — may demand such a change if they believe Obama and Senate Democrats will stand firm on their support for stronger language than the current House language.

 “I have to be able to reassure my constituents that those who are here illegally cannot avail themselves of the provisions provided in this healthcare bill,” said freshman Democratic Rep. Gerry Connolly (Va.). “The Senate language may tighten that up a bit.”

Connolly said he wouldn’t necessarily need the Senate language to allay his concerns, but he said that he can’t make that determination until he sees the final language of the bill.

“You’ve got real competing interests among Democrats in the House over abortion and immigration, and I believe the immigration issue is the more significant of the two,” he said.

Pelosi still dealing as vote nears
By: Patrick O’Connor
November 6, 2009 05:09 AM EST

House Speaker Nancy Pelosi has conjured up plenty of old ghosts since launching the health care fight back in July, invoking Democrats who laid the foundation for this year’s push — like Franklin Roosevelt and Harry S. Truman.

In a way, those titans came up short. Pelosi owes her current place on the cusp of a historic health care vote Saturday to far more anonymous contemporaries, like New Jersey Rep. Robert Andrews and California Rep. Xavier Becerra, whom Pelosi sent out to get the votes.

The fate of the bill itself rests on the shoulders of a new generation of Democrats whose young careers will be defined, in part, by the votes they cast Saturday — votes sure to be used against many of them in 2010.

But Pelosi, ever mindful of the political stakes, seems to have convinced them that there is more danger in not passing a bill after all this time, than in passing one. It just had to be the right bill, one that tried to take into account the whims of her caucus — with a provision here, and language there and compromise over there, that built a majority vote by vote.

Yet all the deal-making signaled that the ever-pragmatic Pelosi was keenly aware of the limits to her own power, reminding her rank and file, “We have to work this out because this has to work in your district.”

Freshmen Reps. Jared Polis of Colorado and Gerry Connolly of Virginia, for instance, organized their fellow freshmen to ask the speaker to raise the income threshold for the so-called “millionaire’s tax” to ensure small business owners wouldn’t bear the burden for reform.

In dealing with the speaker, Polis and others suggested the key was to keep your list short and if she could deliver, live up to your end of the bargain.

Our ask was something she could do,” Polis said. “Ultimately, they decided to move the bill in the right direction.”

Added Andrews: “Every member was given real input into the bill. This is pretty rare. Normally, the chairman writes the bill, and the whip goes out and gets the votes.”

But Pelosi’s not there yet, as she acknowledged Thursday — saying she’ll have the 218 votes by the time she needs them. Last-minute flare-ups on abortion and immigration Thursday threatened to complicate the bill — but at this point didn’t seem enough to derail it.

Members of the Congressional Hispanic Caucus fought back against reports that leaders would add Senate language to block illegal immigrants from participating in the insurance exchange. New York Rep. Nydia Velazquez, the chairwoman of CHC, said they told the president during a White House meeting Thursday afternoon that the caucus has 20 votes for the current immigration language and would oppose the verification requirements in the Senate bill. Obama was receptive to their concerns, she said.

And a small group of anti-abortion Democrats, led by Indiana Rep. Brad Ellsworth, continued haggling over the final language to ensure federal funds can’t be used to pay for abortions under programs created by the bill.

Negotiators are working closely with the United States Conference of Catholic Bishops to finalize language the church can accept. Vulnerable anti-abortion Democrats don’t want to support any bill that the bishops haven’t signed off on.

The speaker won support for the bill Thursday when AARP and the American Medical Association both announced they were backing the House bill.

Their support proved important enough for President Barack Obama to make a surprise appearance in the White House briefing room to tell Congress that it ought to heed the two powerful lobbies.

“We are closer to passing this reform than ever before, and now that the doctors and medical professionals of America are standing with us, now that the organizations charged with looking out for the interests of seniors are standing with us, we are even closer,” Obama said.
Obama himself will come to Capitol Hill on Friday to make a personal pitch to House Democrats. The president’s audience includes first-year Democrats from often-overlooked parts of the country who came to Congress on Obama’s coattails, like Reps. John Boccieri from northeast Ohio, Kathleen Dahlkemper from northwest Pennsylvania and Thomas Perriello from Virginia’s Southside. Their votes are critical to his success, just like his voters were critical to theirs.

From the beginning, the bill has been the sum of the caucus parts.

The low-profile Becerra has taken the lead in negotiating with a handful of aggrieved constituencies, balancing the priorities of his lower-income largely Hispanic constituents with those of his party. And Andrews has become something of an in-house expert on the legislation who explains portions of the bill to confused colleagues and even more confused members of the press.

A collection of Democrats spent months haggling over Medicare’s controversial reimbursement rates. The House Education and Labor Committee based a key component of its bill — banning insurance companies from discriminating against the sick and most expensive to insure — on a bill first introduced by Connecticut Rep. Joe Courtney. And the entire caucus went back and forth for weeks on what form of government insurance to include in the final bill.

First-year Democrats were particularly productive. Dahlkemper and North Carolina Rep. Larry Kissell persuaded the speaker to add billions to expand coverage for young people. And New Mexico Rep. Ben Ray Lujan, another freshman, pushed for the addition of money for American Indian health care programs.

Party leaders have had to baby-sit this process, but they are rarely the loudest voices in the room.

Minnesota Rep. Betty McCollum, who rarely speaks in caucus meetings, was among the first to raise the Medicare reimbursement issue with her colleagues, arguing one day that the historic imbalance tends to direct more money to doctors and hospitals in urban areas at the expense of less-populated regions that often get better results for less money. After she spoke, the speaker turned to her and said, “Yes, that’s not fair.”

When Pelosi did try to pound her caucus in place, the votes weren’t there, forcing her to retreat on a public plan in which doctors and hospitals would be paid 5 percent higher rates than Medicare, even though she lost more than $80 billion in savings in the process.

But Pelosi’s patience has its limits, and she occasionally let her frustration show, publicly questioning the always-agreeable Earl Pomeroy about which way he would vote when the North Dakota Democrat questioned the inclusion of a controversial long-term care program.

However, the speaker called Pomeroy a few days later to let him know that it looked like his top priority — a public option that lets doctors and hospitals negotiate rates with the government — would be included in the final bill. By the end of the 10-minute chat, Pomeroy seemed to suggest he was willing to back the bill.

And so last week, before she and her colleagues marched outside to the West Front of the Capitol to unveil their bill, the speaker apologized to Pomeroy in front of the entire caucus after trying to embarrass him in the same room a week earlier.

Touched, Pomeroy apologized, too, prompting Connecticut Rep. John Larson to joke that they were having a “real ‘Kumbaya’ moment.”

Pomeroy, who had been on the fence, took that moment one step further when he told his colleagues that he was ready to support the bill. They returned the favor by giving him rousing applause.

“When negotiated rates were in there, I felt duty-bound to support the bill,” Pomeroy said.