A deal has not yet been reached between the White House and congressional Republicans on the American Health Care Act, the bill intended to repeal and partially replace ObamaCare. Many Republicans have been unable to rally around the bill, asserting that it breaks too many promises made to the American people during the 2012, 2014, and 2016 election cycles. The latest disappointment involves the removal of a provision intended to stop illegal immigrants from receiving health insurance coverage from the bill. The change has made an already widely unpopular bill even more so.
Reuters reports that the dropped provision would have opened up lines of communication between the Treasury Department and the Department of Homeland Security to ensure that all individuals receiving healthcare tax credits were U.S. citizens of legal permanent residents. Without it, the Department of Health and Human Services and IRS will not be able to check Social Security numbers to confirm that individuals are legal citizens.
Conservative author Daniel Horowitz said that the change is “a gift to illegal aliens,” adding that it makes even basic immigration enforcement impossible. In a piece for the Conservative Review, he explains,
The problem with this bill is that because it tweaks ObamaCare and creates a new massive entitlement system through the budget reconciliation process, it cannot have the statutory effect of mandating HHS and IRS work with Citizenship and Immigration Services to use the SAVE database because that issue is outside the jurisdiction of the reporting committees.
According to Reuters, removing the provision from the bill was “largely procedural,” as it was removed “after the Senate parliamentarian determined that the Senate Finance Committee, which handles tax credits under the bill, does not have purview over the Department of Homeland Security.”
Lauren Aronson, spokeswoman for the tax-writing House Committee on Ways and Means, has attempted to assuage concerns over the missing provision by stating that the bill maintains ObamaCare policies that permit only American citizens and legal permanent residents to receive tax credits.
But it has been widely reported that illegal immigrants had been receiving healthcare subsidies under ObamaCare, regardless of the law.
According to the 2016 Senate report by Republicans on the Senate Homeland Security and Governmental Affairs Committee, as of June 2015, “The Administration awarded approximately $750 million in tax credits on behalf of individuals who were later determined to be ineligible because they failed to verify their citizenship, status as a national, or legal presence.”
And like Republicans who had promised to address this flaw in ObamaCare in their healthcare replacement bill, President Obama had promised that ObamaCare benefits would not be made available to illegal immigrants either. "There are also those that claim our reform efforts would insure illegal immigrants. This too, is false. The reforms I am proposing do not apply to those who are here illegally," Obama insisted during a 2009 speech.
What’s worse is that no efforts were made to recover the money, according to that same Senate report, which stated,
The information provided to the committee by the IRS and HHS reveals a troubling lack of coordination between the two agencies ... and demonstrates that the IRS and HHS neglected to consider how they would recover these wasteful payments.
The removal of the immigration provision from the American Health Care Act has further marginalized some of the stricter conservatives who already had a difficult time supporting the bill, which critics have dubbed “ObamaCare-lite.”
"I am concerned that the bill lacks sufficient safeguards for verifying whether or not an individual applying for health care tax credits is lawfully in this country and eligible to receive them," said Pennsylvania Republican Representative Lou Barletta. He announced that he can no longer support the bill as it stands.
He’s not the only one.
The conservative House Freedom Caucus maintained their hardline stance against the bill in a meeting with President Trump earlier today, despite reportedly being delivered a “final offer,” according to chief deputy whip Patrick McHenry. "This is the final offer," McHenry said. "We have a package, they have an offer, and they can accept or reject it."
Representative Andy Harris (R-Md.) said that despite some of the recent changes to the healthcare bill, including removing federal requirements that health insurance plans provide a basic set of benefits, he could not support it. “This legislation simply won’t lower premiums as much as the American people need, and lowering the cost of coverage is my primary goal,” said Harris, an anesthesiologist and Freedom Caucus member.
Though a vote is expected today on the healthcare bill, Freedom Caucus Chairman Mark Meadows said there's no deal yet. "There are not enough votes as of 1:30 p.m. today," he told reporters.
According to a Quinnipiac University poll, just 17 percent of American voters support the Republican health plan and that 46 percent of voters say they are less likely to vote for their congressman if he or she votes for the replacement plan. Just 41 percent of Republican voters surveyed in the poll supported the GOP bill.
The poll also shows that just 29 percent of voters approve of Trump’s handling of healthcare at the moment.