When President Clinton signed welfare and immigration reform bills into law last summer, he promised furious Democratic liberals that he would work to ease the burdens of those measures on legal immigrants.
Republicans said at the time they had no intention of reopening the measures, which restrict Medicaid benefits for many immigrants. The bills cut off benefits for immigrants whose only link to the Medicaid program was through their eligibility for other welfare programs.
Now, however, it appears GOP leaders are bowing to pressure from the nation's governors and provider groups and have agreed to restore as much as $4 billion of $5.5 billion in Medicaid benefits over the next five years for some legal immigrants as part of the budget accord reached earlier this month. And a separate bill designed to provide relief for flood victims in the Midwest includes an amendment that would restore $125 million in Medicaid benefits to legal immigrants for the duration of fiscal 1997, which ends Sept. 30. The bills would affect 330,000 of the 500,000 legal immigrants slated to lose their Medicaid benefits.
Provider groups say continuing healthcare funding for legal immigrants is necessary to ensure they seek care on a timely basis and to reduce the amount of uncompensated care. Cutting the Medicaid benefits, providers say, would unfairly penalize hospitals, particularly public hospitals.
Carla Luggiero, senior associate director of congressional and executive branch relations at the American Hospital Association, said many immigrants "are fearful to come in if their immigration status is going to be questioned. This would also mean that at least hospitals would be compensated for care given."
Christine Burch, executive director of the National Association of Public Hospitals, said the legal immigrant funding is important to hospitals.
"This is a significant issue for our membership," Burch said. "We still have to deal with significant (Medicaid disproportionate-share payment) cuts and this would help soften the impact."
The measures would affect only immigrants who were in the country legally as of last August when President Clinton signed the bills into law. New legal immigrants would still be subject to the restrictions on welfare and Medicaid.
Both the short-term fiscal 1997 funding measure and the five-year restoration of Medicaid benefits have broad bipartisan support. However, in Washington that doesn't necessarily translate into swift enactment.
The disaster relief bill is being held up in Congress over issues not related to the Medicaid-immigrant issue, and the budget agreement is still little more than a broad framework that has yet to be voted on in either house of Congress.