By Joseph Miller, Federal Affairs Intern

Last week, we blogged that the Senate would begin debating S. 744, comprehensive immigration reform legislation – and they have.  Not to be left behind, the House has snapped into action as well, starting the committee markup process for several smaller bills (versus a single., comprehensive bill) and approaching immigration reform piecemeal.  Here’s where the action is this week on both sides of the capitol.

Senate-side:  Floor Debate Continues, Amendments Abound

Just one week into the Senate Immigration debate there are 100+ proposed amendments to be considered.  Although not all of the amendments will be voted on, there are a few high-profile amendments the media is watching this week on border security, enforcement, and the pathway to citizenship, for example,.  The  outcomes of these particular amendments may in fact impact the ultimate success of the reform effort.  One of the most contentious issues moving forward, will be health care for illegal immigrants will be an ongoing debate ; Senators Orrin Hatch (R-UT) and Marco Rubio (R-FL) are proposing lengthening the time before illegal immigrants can receive health benefits, whereas Senator Mazie Hirono (D-HI) will offer an amendment that allows all taxpayers to receive federal benefits like Medicaid.  There will be many amendments like these proposed and voted on over the next few weeks that could dramatically impact the delivery of health care in the future.  But Senate majority leaders  still remain optimistic  they’ll pass a comprehensive immigration bill by the July 4^th recess and ensure a pathway for undocumented immigrants to finally have a pathway to citizenship.  In fact leadership has even said they are willing to work weekends until the bill is passed.

House-side:  Immigration Reform Picks Up Steam, One Bill at a Time

Although they are a few weeks behind, the House is not sitting idle while the Senate tries to pass their version of immigration reform.  This week the House Judiciary Committee will begin marking up two separate immigration bills: the “Strengthen and Fortify Enforcement Act” (H.R. 2278) and H.R. 1773, the “Agricultural Guestworker Act” (H.R. 1773). Unlike the Senate, the House is trying to pass individual bills to reform immigration policy bit-by-bit, rather than in a comprehensive, overarching manner.  As in the Senate, health care for immigrants has emerged as a heated topic of discussion in the House and we have already seen Rep. Raul Labrador (R-ID) drop out of bipartisan talks in the House’s “Gang of Eight” over the treatment of health care benefits for newly legalized residents.  Members are engaging in intense discussions around emergency care for illegal immigrants and access to benefits, among other issues, but House majority leaders also remain hopeful they can pass legislation by the end of the month.

By Joseph Miller, Federal Affairs Intern

After months of discussion and deliberations, the Senate will begin debating  comprehensive immigration reform on the floor this week.  The Senate immigration overhaul, the 800+ page “Border Security, Economic Opportunity, and Immigration Modernization Act” (S. 744), which we discussed here on the blog when it was introduced by the bipartisan Gang of Eight back in April, went through a number of changes during the Senate Judiciary Committee mark-up process last month and will likely be amended further as it moves through the floor debate and toward a final Senate vote.  We can expect proposed amendments and debate on many issues in the coming days and weeks, including border security, access to health care coverage, and immigrant visas, but the Senate majority leadership has indicated that they hope to pass bipartisan legislation before the July 4^th recess.  You can watch the floor debate live as it progresses here on C-SPAN – and stay tuned to the blog, where we will provide updates on the immigration reform bill as it changes and additional analysis on key issues for health centers and their patients.

Senators John Thune (R-SD) and Bob Casey (D-PA) last week introduced S. 955, the Family Health Care Accessibility Act of 2013. This legislation would reduce unmet primary care need in communities by encouraging licensed practitioners to volunteer at Community Health Centers. With 60 million Americans lacking access to care, this legislation is a no-cost solution that would allow Health Centers to keep up with the increasing and overwhelming demand for services.

Currently, CHC employees, contractors and board members receive medical malpractice protection under the Federal Tort Claims Act (FTCA). However, licensed health care professionals seeking to volunteer their services at a CHC must provide their own independent medical malpractice coverage, sometimes at a cost of more than $100,000 per year.  This has proven to be a significant hurdle to volunteerism at CHCs.

S. 955 seeks to resolve this workforce barrier by enabling licensed  health professionals to volunteer their services to meet critical provider need by removing the cost prohibitive barrier of providing their own medical malpractice coverage. Specifically, the legislation would amend the Public Health Service Act to extend FTCA malpractice coverage to qualified licensed health care practitioners who volunteer at Section 330-funded health centers.

We applaud the leadership and continued support of Senators Thune and Casey on this very important issue for health centers. NACHC’s press release on the Family Health Care Accessibility Act of 2013 can be viewed here. The Dear Colleague letter being circulated by Senators Thune and Casey can be viewed here. This legislation passed in the House of Representatives during the 111th Congress by a vote of 417-1 and there is strong bipartisan support for the legislation. We encourage health center advocates to contact their Senators and ask them to show their support by becoming a cosponsor of S. 955.

Last Wednesday morning, a bipartisan group of eight Senators introduced the Border Security, Economic Opportunity, and Immigration Modernization Act of 2013. This bill, developed by Senators Schumer (D-NY), McCain (R-AZ), Durbin (D-IL), Graham (R-SC), Menendez (D-NJ), Rubio (R-FL), Bennet (D-CO), and Flake (R-AZ), is just the starting point for immigration reform discussions in the Senate.
The legislation focuses largely on border security and the initial years of implementation will focus on securing the border and eliminating the backlog of current Lawful Permanent Residents who are applying for citizenship. Accordingly, the bill contains instructions and requirements to expedite and streamline the current path to citizenship for current Lawful Permanent Residents, including adjusting the number and types of available visas. It also creates a pathway for currently undocumented persons living in the United States to gain “Registered Provisional Immigrant Status” once border security requirements are established and well underway. There are a number of requirements and fees associated with gaining RPI status, however after a period of 10 years individuals with RPI status could transition to Lawful Permanent Resident Status in order to begin the process that would eventually result in a green card.
Of note, individuals in RPI Status would not be permitted to access health care coverage in the Exchange—even if purchased with their own money—nor would they be able to access Medicaid or Medicare benefits. Lawful Permanent Residents who become citizens in an expedited manner will, however, become eligible for such benefits sooner than they otherwise would be. This proposal is just the starting point for immigration discussions and that all of this remains on the table. Numerous Senators and Senate Committees have already staked a claim on wanting to make sure their input is considered and Members in the House are beginning their initial discussions as well. We at NACHC are focused on the ongoing discussions and plan to be engaged as the process continues over the coming weeks and months. Stay tuned for more information as it becomes available!

Last week, the President’s released his FY2014 Budget Proposal. Under the proposed budget, the Health Centers Program would receive a total programmatic level of $3.8 billion. This $700 million increase above FY2013 is comprised of funds previously appropriated through the Affordable Care Act and could enable Health Centers to expand access to care to more than 5 million new patients if fully utilized. You can view the NACHC statement on the President’s Budget Proposal here.

The Senate FY2014 Health Center support letter is now open for signatures. The bi-partisan letter led by Senators Debbie Stabenow (D-MI) and Roger Wicker (R-MS) will be circulating until Wednesday, April 24^th. Information on the Senate letter will be posted here as soon as it is available. Senators can also submit their individual funding priorities to the Appropriations Committee on what is known as their wish list until Friday, April 26^th. We would ask all Health Center Advocates to reach out to their Senator to ask them to support health centers by signing on to the Stabenow-Wicker letter and by including health center funding on their individual wish list.

As a reminder, the bi-partisan Bilirakis-Pallone FY14 Health Center funding support letter is still open for signatures in the House until Wednesday. Health Center Advocates have 2 days to follow up with their Representatives to sign on to the Bilirakis-Pallone letter. Advocates can see a list of current cosigners here.  As a reminder, Members have until April 22^nd to submit individual programmatic request in support of the Health Center Program.