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Border Security, Economic Opportunity, and Immigration Modernization Act--Continued--

Floor Speech

Location: Washington, DC


Mr. ROCKEFELLER. Madam President, I would like to take a few moments with my friend Chairman Leahy to discuss the ongoing importance of the Children's Health Insurance Program Reauthorization Act's impact on lawfully residing noncitizen children and pregnant women. In that 2009 legislation, States were given the option to provide Medicaid and State Children's Health Insurance Program--CHIP--benefits to these populations without first imposing a waiting period, and many did so as an investment in future generations. Throughout the debate on S. 744, some of my colleagues spent a considerable amount of time seeking to deprive lawfully present noncitizens of the protections of our vital safety net programs. I consider these efforts to be contrary to the value that we, as Americans, place on protecting the most vulnerable among us.

Chairman Leahy's leadership has been critical to the passage of this historic legislation in the Senate, and I thank him for being a strong voice in favor of protecting health care benefits for children and pregnant women. As you know, children's health has been one of my top priorities throughout my time in the Senate. Although the immigration reform bill that passed the Senate does limit certain noncitizens' eligibility for some Federal benefits, I am pleased the Senate chose to preserve States' rights to extend full Medicaid and State Children's Health Insurance Program benefits to children and pregnant women granted legal status under the bill, particularly individuals and families granted Registered Provisional Immigrant--RPI, Blue Card, and V-visa status.

Commonly referred to as the Immigrant Children's Health Improvement Act--ICHIA, the success of this State option cannot be overstated. In the 4 years since its passage, 27 States and territories have decided to exercise the option to extend coverage to lawfully residing noncitizen children or pregnant women under Medicaid or CHIP without first imposing a waiting period: California, Colorado, Connecticut, Northern Mariana Islands, District of Columbia, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Texas, Vermont, Virginia, Washington, and Wisconsin. This extension of coverage has literally been a lifeline to children and pregnant women who cannot afford to wait 5 years for immunizations, treatment of infections, prenatal care, and other necessary medical services.

Because the bipartisan immigration bill contains multiple provisions relating to certain noncitizens' eligibility for federal benefits, including those under means-tested programs, I would like to take some time to walk through how the Senate-passed immigration bill does not in any way limit a State's ability under ICHIA to extend coverage to children and pregnant women who receive RPI, Blue Card, or V-visa status.

Under the Centers for Medicare and Medicaid Services'--CMS--guidance on the definition of ``lawfully residing'' in ICHIA, as long as a noncitizen child or pregnant woman has established residency in a State and is ``lawfully present'' in this country, he or she may qualify for benefits at the State's option. Children and pregnant women granted RPI, Blue Card, and V-visa status as part of the bipartisan immigration bill clearly meet this definition. The bill explicitly states that these categories of noncitizens are ``lawfully present'' in the United States for all purposes, except for specific benefits and obligations under the Affordable Care Act.

I will now turn it over to Chairman Leahy to provide some additional context from the Senate negotiations and the Judiciary Committee mark-up of S. 744.


Mr. ROCKEFELLER. Now, I would like to direct a question to my friend Chairman Leahy. Just to be clear, provisions in the bipartisan immigration reform bill do not eliminate a State's right to extend Medicaid and CHIP to any lawfully residing noncitizen child or pregnant woman, including those receiving RPI, Blue Card, or V-visa status. Is this correct, Mr. Chairman?


Mr. ROCKEFELLER. A closer look at the language in PRWORA and the Social Security Act confirms that the immigration reform bill does not eliminate the States' right to use the ICHIA option to provide coverage to lawfully residing children and pregnant women. The States' option to extend coverage to these individuals is not ``implemented'' in section 403 of PRWORA, the provision of law impacted by the immigration bill, but instead exists independent of PRWORA under sections 1903 and 2107 of the Social Security Act.

I would also like to point out to our colleagues that the Congressional Budget Office--CBO--had a similar interpretation of the language in S. 744. CBO made an assumption that, under this language, Federal agencies would permit some individuals with RPI, Blue Card, or V-visa status to receive benefits from Federal means-tested programs, and specifically incorporated into its estimate of the bill the costs of providing Medicaid and CHIP coverage under ICHIA to children and pregnant women.


Mr. ROCKEFELLER. Moreover, by using the term ``waive'' in section 2323, the Senate is attempting to prohibit Federal officials from using their waiver authority under certain means-tested programs--such as those afforded to agencies in relation to demonstration projects--in a way that would result in noncompliance with PRWORA. This narrow prohibition on the use of waivers by Federal officials cannot be construed to prevent the continued implementation of an explicit, independent statutory right afforded to the states under ICHIA. The ICHIA option is not a waiver and remains available for States regardless of any action by an ``officer or employee of the Federal Government.''


Mr. ROCKEFELLER. I share the Chairman's disappointment that the Senate decided to add section 4417 to explicitly exclude students and tourists from ICHIA coverage, but I also agree with him that by not excluding other categories of lawfully residing noncitizens in section 4417, such as those granted RPI, Blue Card, or V-visa status, the Senate intended to preserve their benefits.

One of the hallmarks of our Nation is our willingness to protect the most vulnerable among us. People from all over the world want to be part of America because of our deeply-rooted respect for human dignity.

Although it is not perfect--few laws are--the bipartisan immigration bill passed by the Senate this week lives up to those values in so many ways. It brings millions of hard working people out of the shadows, gives young students an opportunity to earn citizenship by furthering their education or serving in the military, reunites families who yearn to spend time with their loved ones, protects victims of domestic violence, and preserves health care coverage for noncitizen children and pregnant women who earn legal status under the bill.

Immigrants are not under any illusions that they will qualify for lavish benefits under our Federal programs when they arrive on our shores. But under this bill, they at least know that when medical needs arise or a medical disaster strikes, the vast majority of noncitizen children and pregnant women will be covered.

I yield the floor.


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