WASHINGTON – Senators closing in on a comprehensive health care bill have whittled away all but the most contentious issues and one of those loomed large Friday: coverage for illegal immigrants.
Negotiators on the Senate Finance Committee thought they'd already resolved the question. That was before Republican Rep. Joe Wilson's shout of "You lie!" as President Barack Obama said in a speech Wednesday that illegal immigrants wouldn't be covered under his health plan.
That led senators to revisit the issue to make sure they have provisions in place to enforce prohibitions against illegal residents getting federally subsidized coverage.
"What we are trying to prevent is anyone who is here illegally from getting any federal benefit," said Sen. Kent Conrad, D-N.D., a member of the so-called Gang of Six of three Democratic and three Republican members of the Finance Committee. The group is facing a deadline early next week to produce a bipartisan deal.
If they don't succeed, Chairman Max Baucus, D-Mont., plans to go it alone with a Democratic bill.
The outcome remains very much in doubt. A successful effort could form the basis for legislation that could appeal to a majority in the Senate since the Finance Committee has a moderate makeup that resembles the Senate as a whole.
This weekend will be critical as aides and lawmakers themselves hammer out language not just on illegal immigration, but also a handful of other thorny issues including abortion, medical malpractice and how much states must pay for an expansion of Medicaid.
The deal-or-no-deal question could be answered as early as Monday when the group meets again.
"Obviously we'll find out who wants to support the (bill) and who doesn't," Baucus said Friday. "I'm hopeful that there will be bipartisan support. And I'll keep working on it frankly over the weekend, on the telephone talking to people, so on and so forth."
Baucus' plan largely mirrors what Obama laid out in his speech Wednesday: expansion of coverage to most of the nearly 50 million uninsured, new requirements for individuals to obtain insurance, new prohibitions against insurance company practices like denying coverage based on personal health history and creation of a new marketplace called an exchange where consumers could shop for different health plans.
If Congress ends up creating a new government-run insurance plan it would be offered through the exchange, but unlike the four partisan bills that have emerged from committees in the House and Senate so far, Baucus' bill will substitute nonprofit co-ops for the public plan.
The White House says that Obama does not want illegal immigrants to be able to buy insurance through the new purchasing exchange as they would be allowed to do under Democratic legislation in the House. Spokesman Robert Gibbs said the White House will work with lawmakers on language to enforce that.
"Illegal immigrants would not be allowed to access the exchange that is set up," Gibbs said Friday. Verification requirements are "something we'd work out with Congress," he said.
The illegal immigrant controversy that led to the outburst from South Carolina's Wilson stems from Republicans' contention that illegal immigrants would be able to get federally funded health coverage under the House health bill — even though the bill expressly prohibits federal subsidies for illegals.
Critics note that there are no enforcement mechanisms, or language on how to verify whether or not someone is in this country legally.
"Without a verification requirement it's essentially like posting a 55-mph speed limit and not having any highway patrol on the road," said Ira Mehlman, spokesman for the Federation for American Immigration Reform.
Democrats in two House committees defeated amendments that would have required verification of legal status. Many Democrats contend that such measures create barriers to legal residents getting the health coverage they need.
Verification provisions added to Medicaid several years ago require people to provide documentation of citizenship and identity, said Jennifer Tolbert, a policy analyst at the nonpartisan Kaiser Family Foundation.
She said states found that the new requirements mainly caused delays or denials for people who were entitled to be part of the program.
There are some 7 million illegal immigrants in this country who lack health insurance, according to the Pew Hispanic Center.
Unlike in the House bill or legislation passed by the Senate's health committee, the Finance Committee is aiming to include verification requirements. Anyone who tries to get subsidized care through a new health insurance exchange would have to provide valid Social Security numbers. Aides are working through the weekend to complete how that requirement would be implemented.