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Immigration to Further Complicate Health Fix

Questions Likely Over Coverage of Workers

House Democrats leading the charge on health care reform will soon have another major hurdle to overcome beyond public options and employer mandates: immigration reform.

The issue of undocumented workers receiving health care benefits is one that remains largely untouched amid talks on a health care overhaul, but one that is likely to soon bubble up.

“We’re going to confront immigration issues in the health care measure,— said one senior Democrat involved in negotiations on the bill. “We all recognize that as we continue to talk about all the components of health care reform, the issue of immigrants will come up, legal and undocumented. We have to figure out how to deal with them.—

The lawmaker said Democratic leaders have raised the issue with committees overseeing health care reform and asked them to address it in their discussions on the legislation.

Topics being discussed include “everything you can think of that would implicate an immigrant,— the Member said. “What do you do with coverage for the undocumented? What do you do with a temporary worker who’s here only to work? What do you do with a student here on a visa? All those issues are now being discussed.—

At this stage, however, there have been no discussions on how to link them to health care legislation, the lawmaker added.

Democratic leaders resoundingly support immigration reform. But they have given little insight into when and how they plan to move forward on the contentious issue.

Moving too quickly to pass a major overhaul could jeopardize other high-priority bills on the schedule; waiting too long could rile Latinos in their party.

Key negotiators on the health care bill either steered clear of the issue or pointed out how most lawmakers prefer to do so.

“I don’t know if it will play a role in this bill. I don’t think we’ve come to that issue yet,— House Energy and Commerce Chairman Henry Waxman (D-Calif.) said. “There’s too many other issues that we’re dealing with.—

House Ways and Means Chairman Charlie Rangel (D-N.Y.) was even more circumspect. “Undocumented workers? Undocumented people?— he said with an incredulous tone. “This Congress never likes talking about things like that.—

Rangel wouldn’t say if or how the issue might surface in health care legislation. But the reality is that a large number of people, including undocumented residents, “are going to continue to receive [public] health services, and we will be providing for … benefits, community health centers, emergency rooms,— he said.

Some Republicans are already predicting the issue will come to the forefront as health care unfolds in the coming months.

“I just can’t believe it won’t be brought up,— said Rep. Brian Bilbray (R-Calif.), chairman of the Immigration Reform Caucus.

Bilbray said Congress will have to discuss whether health care reform “for everyone— will include coverage for the estimated 12 million to 20 million illegal immigrants in the country. He said any piece of legislation will have to include E-Verify, a computer system that links a person’s Social Security number to eligibility for health care services.

Without E-Verify, Democrats “will be allowing public funding to people who are illegally in the country,— Bilbray said.

While the intersection of immigration and health care reform may be unavoidable, several Democratic lawmakers and aides noted that nobody wants to touch the issue for now since negotiations on health care reform are already so delicate.

“We’re just in the initial stages right now,— one senior House Democratic aide said. The role of undocumented workers “hasn’t been our focus yet. It’s like the third rail here.—

Still, the aide continued, lawmakers will have to look at undocumented residents when it comes time to address how to move people out of emergency rooms — the default source of health care for many illegal immigrants — and into preventive health.

“The real question comes, if there’s a public option, how do you deal with that? I don’t know,— the aide said.

The Congressional Hispanic Caucus has made immigration reform its No. 1 priority this year and is presenting itself as a force to be reckoned with on the issue.

“There’s very little space between any member of the caucus on immigration, which is excellent,— House Democratic Caucus Vice Chairman Xavier Becerra (Calif.) said.

“Now you have 20-some-odd Members who I think are ready to act as a unit on issues that are very important on, say, immigration. I guarantee you, there aren’t that many caucuses that can actually hold their Members on really crucial issues like that,— Becerra said.

Added another CHC member: “We are advocating everywhere: the Senate, the House, the White House.— Immigration, the Member said, is the issue that “trumps all the other stuff that is before us right now.—

While Democratic leaders may want to hold off on the issue to take on other domestic priorities, this lawmaker insisted there is no time like the present.

“It’s never the right time. There’s an economic upswing, Oh, we can’t jeopardize that.’ There’s an economic downswing, people are panicking,— he said.

Still, there are some top Democrats who say they doubt that immigration matters will have a role in health care reform.

“We’re going to deal with these as separate issues,— Democratic Congressional Campaign Committee Chairman Chris Van Hollen (Md.) said. He noted recent comments by Senate Majority Leader Harry Reid (D-Nev.) indicating his interest in tackling immigration reform in a comprehensive manner, not in a piecemeal approach.

Other lawmakers point out that even if Democrats don’t want to talk about undocumented workers during the health care debate, they may have no choice given how the issue resonates back home.

“The flu doesn’t discriminate based on citizenship,— Rep. Dennis Cardoza (D-Calif.) said, adding that he has a lot of legal and undocumented immigrants in his district. “There are a whole lot of issues that are going to have be dealt with.—

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