Health Care | Immigration

Letter Opposing Bill That Would Take Health Care Away from Immigrants

Dear Representative:

The AFL-CIO urges you to oppose “The Verify First Act” (H.R. 2581), a bill that would deny Americans the insurance subsidies now available under the Affordable Care Act (ACA), or the contemplated American Health Care Act, until the Department of Health and Human Services (HHS) verifies their U.S. citizenship or immigration status.

Advance tax credits make health insurance under the ACA exchanges more affordable by paying the consumer's expected tax credit to the insurance provider who then uses the payment to reduce the premium it charges to the consumer. Under current law, if the information the consumer provides in her application is incomplete or not immediately consistent with federal databases, she can nonetheless benefit from the subsidy payments for a 90-day "consistency period" while she and the HHS agency endeavor to locate the necessary eligibility proof. The process of producing the necessary physical documents can be arduous and long.

This bill’s elimination of advance tax credits until eligibility conclusively has been proved will make insurance on the exchanges unaffordable for all those who are eligible for ACA benefits, but who lack immediate access to certain documents or who must respond to database errors. It would disproportionally affect those who have changed their names due to marriage, are lawfully present immigrants, or who recently have become naturalized citizens. There can be no dispute that unaffordable health care effectively prevents people from obtaining access to the care they need, and the way in which this bill will delay individuals’ coverage may well lead to disastrous health outcomes.

Bill supporters cite a Senate Homeland Security and Government Affairs Committee report that assumed that all those who lost coverage for failure to verify their citizenship and immigration status were undocumented. This assumption disregards the system outages and other technical problems that contributed to failure of the federal Health Insurance Exchange to verify consumers’ status promptly during the first year of ACA implementation. Despite huge improvements since then, problems persist. The Social Security database, holding many citizens’ information, is notoriously inaccurate and not updated regularly to accurately reflect common changes, such as a new last name because of marriage or a newly naturalized U.S. citizen.

In sum, H.R. 2581 represents poor public policy, denying many Americans the healthcare for which they otherwise would be entitled. We urge you to oppose it.

Sincerely,
William H. Samuel, Director
Government Affairs Department