Healthcare News January 30, 2013

  • OVERNIGHT HEALTH: Obama plan nixes health benefits for immigrants in the pipeline

    President Obama unveiled his immigration proposal Tuesday, and according to the White House, the plan would bar immigrants with provisional legal status from accessing benefits under the Affordable Care Act. In this way, the plan echoes the principles unveiled Monday by a group of eight bipartisan senators. That plan would also prohibit the immigrants it legalizes from benefiting from federal health programs.

    The language is confusing here: both proposals would “legalize” a vast swath of residents who are now undocumented, but instead of joining the ranks of legal permanent residents, these immigrants would have a “provisional” or “probationary” status, apparently barring them from receiving the federal benefits permitted for citizens and most green-card holders. Those benefits include eligibility for the now-in-progress insurance exchanges, related tax credits and Medicaid (after a waiting period).

    “Legal immigrants,” as the term is traditionally understood, will also be subject to the individual mandate to buy healthcare coverage when it takes effect next year.

    To dig a little deeper, the Affordable Care Act states that non-citizens are eligible for its benefits if they are “aliens who are lawfully present” in the country. A 2011 analysis of this language by the Congressional Research Service classified as “lawfully present” legal permanent residents, asylum recipients and refugees, and nonimmigrants, including temporary workers and representatives of foreign governments. The only category classified by the CRS as not lawfully present — that is, not eligible for benefits under healthcare reform — are “unauthorized” (“illegal”) aliens.

    The proposals from the White House and the Group of Eight lack detail. They outline objectives for immigration reform, but not how they might be accomplished or what laws might be modified to get there. The process, step by step, for undocumented immigrants to acquire a robust legal status still needs to be fleshed out.

  • Republicans threaten to subpoena IRS records on health law’s subsidies

    House Republicans on Tuesday reiterated their threat to issue subpoenas in their investigation into the Affordable Care Act’s insurance subsidies. 

    Republicans believe the IRS exceeded its legal authority by writing regulations to make the subsidies available in both state-run and federally facilitated exchanges, and have repeatedly asked to review documents about the IRS’s decision making process. 

    They said Tuesday that the agency hasn’t provided responsive documents, and has excessively redacted the documents it has provided.  

  • Rubio: Immigration deal ‘un-doable’ if health benefits are on the table

    Sen. Marco Rubio (R-Fla.) signaled that he will withdraw support from any immigration reform deal that extends federal healthcare benefits to provisionally legal U.S. residents.

    Rubio was speaking with conservative radio host Rush Limbaugh Tuesday when he said that adding millions of new beneficiaries under President Obama’s healthcare law would excessively strain the federal budget.

    “If ObamaCare is available to 11 million people, it blows a hole in our budget and makes this bill un-doable,” Rubio said, referring to a final immigration reform package. 

  • Lobbyists air concerns about doctor gift-disclosure rule at White House

    Lobbyists are lining up to meet with Obama administration officials about rules that would require medical companies to disclose financial relationships with doctors, according to records released by the White House.

    The rules set forth by the Affordable Care Act reached the Office of Information and Regulatory Affairs (OIRA) in November — way behind schedule set by Congress. Interest groups and Congress have since called for the administration to speed the process along. OIRA has up to 90 days to conduct a review, giving it until Feb. 27.

    However, the American Medical Association (AMA), in its most recent meeting, argued that significant changes still need to be made.

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