| In the midst of numerous proposals before the Senate | | | | 2006 stated, "I have learned that the Speaker of the |
| regarding legislation concerning the legalization of illegal | | | | House advised the White House of the differences |
| aliens has arisen a little known provision of the recently | | | | between the House-passed bill and the bill presented |
| signed 2005 Deficit Reduction Act. On February 8, | | | | to the President before the President signed the |
| 2006, President George Bush executed a bill into law | | | | legislation." Representative Waxman is now calling for |
| which now requires recipients of Medicaid benefits to | | | | a Resolution of Inquiry which requests all documents |
| provide either an original birth certificate or passport in | | | | relative to the 2005 Deficit Reduction Act which the |
| order to apply for or to continue to receive their health | | | | President signed on February 8th. So far the White |
| care benefits, commencing July 1, 2006. | | | | House has failed to respond. |
| The Medicaid program, available to American citizens | | | | Whether or not Representative Waxman truly cares |
| who fall into a specified low income bracket, provides | | | | about the Constitution or is doing that which is politically |
| health care to adults and children, as well as the elderly | | | | expedient for himself, is of concern. Firstly, the |
| and those in nursing homes. While much hand wringing | | | | discrepancy in the Senate Bill signed was different in |
| and spin continues in the U.S. Congress regarding how | | | | substance from the House Bill. It impacts some $2 |
| to best deal with the status of illegal aliens, which | | | | billion in spending for "durable medical equipment" such |
| directly impacts costs of U.S. government entitlement | | | | as wheelchairs and oxygen for those in the Medicare |
| programs, this new requirement has yet to be | | | | program, which provides health care to the elderly and |
| discussed. As the result of the newly passed | | | | the disabled. At issue, is the length of leases for |
| Massachusetts universal health care plan, which will | | | | durable medical equipment which was 36 months in |
| include the Medicaid program, the new provision was | | | | the House version and 13 months in the Senate |
| just publicly revealed. | | | | version. |
| However, the present requirements for Medicaid | | | | During transmission of the final bill to the President, the |
| require no such documents, relying only upon a | | | | Senate Clerk made a change to the legislation. It no |
| signature of the applicant to certify whether or not | | | | longer contained the Senate amendment which |
| they are American citizens. And as a result of the | | | | provided for 36 months for oxygen equipment. The |
| unaccountability for Medicaid fraud abuse over the | | | | Senate Clerk upon learning of the mistake advised |
| past several decades, the U.S. government may be | | | | House Republican leaders in January 2006, well before |
| penalizing the vast majority of law abiding citizens, | | | | the date of February 8, 2006, the date the President |
| according to numerous patient advocates. But the | | | | signed the bill. The error failed to be corrected. But |
| issue is more about the continuing lack of enforcement | | | | according to Article I, Section 7 of the U.S. Constitution, |
| of U.S. immigration law rather than an attempt to cut | | | | both the House and the Senate must include the same |
| down on Medicaid fraud. | | | | substance and version of a bill which is required for |
| According to Families USA, a consumer advocacy | | | | presentation for signature by the President. |
| organization, the disabled, the mentally ill, the homeless, | | | | So the entirety of the law has been put in jeopardy |
| the elderly and the chronically ill will unfairly suffer as | | | | and could eventually wind up in the Supreme Court, as |
| the result of this new proviso, as they would have | | | | there exists precedent. In the case of Field v. Clark, 143 |
| difficulty accessing copies of birth certificates, and | | | | US 649 (1892) the Court wrote that the burden would |
| would be far less likely to own a U.S. passport. | | | | be to prove that the House Speaker and President |
| Therefore, they will be unfairly denied necessary health | | | | were deliberate and purposely signing the wrong bill. |
| care beginning as early as July 1st. Meanwhile, hospital | | | | That in fact is what Waxman contends, when on |
| emergency rooms may still not turn away any person | | | | March 15, 2006 he wrote a letter to then White House |
| of any status nor may they ask the legal status of | | | | Chief of Staff, Andrew Card, "seeking information on |
| any patient, according to the Emergency Medical | | | | the President's knowledge of the bill's constitutional |
| Treatment and Labor Act of 1985. | | | | infirmity." |
| While patient advocates may be correct regarding the | | | | While Waxman's inquiry provides interesting fare for a |
| most vulnerable being put at risk, on balance it would | | | | Constitutional Law class, the scope of the 2005 Deficit |
| seem that without addressing social services' access | | | | Reduction Act is perhaps getting lost. The new |
| requirements across the board, with respect to illegal | | | | Medicaid documents requirement being served up as a |
| aliens, it does seem quite unfair to put this burden only | | | | tightening of immigration law enforcement is almost |
| upon Medicaid recipients at this late date in 2006. | | | | laughable. And those patients in wheel chairs and |
| Furthermore, there are no set mechanisms yet in place | | | | those patients requiring oxygen will most likely not be |
| nor systems between federal and state governments | | | | notified of a cap on their benefits until after that period |
| for enforcement of the law. Such a sweeping change | | | | of 13 months expires. Previous to the 2005 law, |
| should require administrative oversight by the Center | | | | wheelchairs and oxygen and durable medical |
| for Medicaid and Medicare and require necessary | | | | equipment were provided patients indefinitely. |
| outreach to patients for this purpose well ahead of | | | | If indeed the President made an error, it should be |
| such changes. | | | | addressed if anything, to give clarity to the Medicaid |
| But perhaps for those desperately trying to get copies | | | | and Medicare patients it impacts. And furthermore, |
| of their birth certificates at this time, there could be | | | | should Representative Waxman pursue the legality of |
| some breathing room as another debate brews | | | | the new law, that he would take the approach that it |
| relative to the validity of the law itself, based upon the | | | | was a procedural oversight which should be either |
| U.S. Constitution. When President Bush signed S. 1932 | | | | amended appropriately or pursued in the present |
| on February 8th, according to House Speaker of the | | | | session of Congress. But it will require the cooperation |
| U.S. House of Representatives, Dennis Hastert, the | | | | of both the Congress and the Executive branch of |
| President actually signed a different version of the bill | | | | government, keeping in mind the most vulnerable of |
| than the House of Representatives actually passed. | | | | U.S. citizens. For there must be some measures of |
| Representative Henry Waxman (D-CA) on March 30, | | | | government which transcend politics. |