Health care reforms aiming for universal coverage won't provide insurance for illegal immigrants and may not address the cost to state and local governments for providing medical care to this large group of the uninsured, the chairman of the Senate Finance Committee said Thursday.
"We're not going to cover undocumented aliens, undocumented workers," Sen. Max Baucus, D-Mont., said at a meeting with reporters. "That's too politically explosive."
Universal health insurance is a key aim of health reform proposals backed by President Barack Obama and key Democrats in Congress, and bills being assembled in House and Senate committees are aiming to reach that goal through a mix of incentives and mandates.
Illegal immigrants, however, account for between 15 and 22 percent of the estimated 47 million U.S. residents without health insurance, according to analyses by the Center for Immigration Studies and the U.S. Census Bureau.
The cost of providing such care has rocked budgets and politics in Texas for several years. About 1.68 million illegal immigrants live in Texas, according to estimates from the Department of Homeland Security.
Many of the uninsured in the Dallas area seek medical treatment at Parkland Health & Hospital System, which reported $512 million in uncompensated expenses for uninsured patients in 2007.
The federal government provides some compensation for hospitals that treat disproportionate numbers of low-income, uninsured patients, but Baucus said his committee has not grappled with whether that should be expanded to cover more of the costs for treating uninsured illegal immigrants.
"I don't have a good answer yet to undocumented workers, illegal aliens," he told reporters at a briefing at the Kaiser Family Foundation in Washington. "There will still be charity care. It's very politically charged."
Some immigration advocates have argued health care reform will be incomplete if it does not extend coverage to illegal immigrants.
"In light of what's happening right now with the flu pandemic, it's pretty clear that, for any health care system to work, it has to cover everyone residing in the United States," said Dr. Jamie Torres, a New York-based podiatrist who is director of Latinos for National Health Insurance.
Margie McHugh of the Migration Policy Institute pointed to Baucus' admission that both coverage and compensation are politically difficult.
"I can't imagine anybody thinks this is true health care reform or a smart element of how to approach the health care reform issue, but it really is just the politics," she said.
If the legislation fails to provide more compensation for health care providers in states like Texas and California, she said, "you really have to wonder if the states are going to stand by and let that happen."
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