Republican leaders hope to finish work as early as this week on a welfare reform plan that would affect Medicaid. The Senate passed the measure last week by a 74-24 vote.
Both the House- and Senate-passed versions include a Medicaid eligibility provision opposed by provider groups that could keep legal immigrants from receiving Medicaid benefits for up to 10 years.
Under the bills, legal immigrants would not be allowed to receive Medicaid benefits for five years under any circumstances. For five years after that, the income and resources of the immigrant's sponsor would be "deemed" to be the same as those of the immigrant.
For example, if a legal immigrant and his sponsoring family have a combined annual income of $100,000, the immigrant would be considered to have income of $100,000, which is well above the threshold for Medicaid eligibility.
Provider groups say that when combined, the two Medicaid eligibility provisions will have the effect of keeping legal immigrants off Medicaid for 10 years.
"The net effect of these provisions would be an abrupt increase in the numbers of uninsured patients seeking care in hospitals," Thomas Scully, president of the Federation of American Health Systems, said recently.
According to estimates by the American Hospital Association, hospitals would take on an additional $10 billion in uncompensated care over seven years.
Before passing the bill, the Senate killed a measure that would have kept more than 5 million poor adults and youths over the age of 13 off Medicaid by breaking the link between Medi-caid and other welfare programs. Many Medi-caid beneficiaries are eligible as a consequence of also being eligible for other welfare programs. The Senate plan would have eliminated dual eligibility, but an amendment by Sen. John Chafee (R-R.I.) killed the provision.
Senate Minority Leader Thomas Daschle (D-S.D.) said the bill was too harsh on legal immigrants and predicted that President Clinton wouldn't sign it. Republican leaders sent a letter to Clinton last week that said they wouldn't compromise further.