Health care at issue in immigration debate

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WASHINGTON -- Health care coverage for newly legalized immigrants is emerging as a thorny issue in Congress' drive to remake the nation's immigration system, posing hard-to-solve problems for Senate negotiators and threatening a bill-writing effort in the House.

The question is how much access to taxpayer-subsidized care should be granted to immigrants who entered the country illegally and are embarking on a path to citizenship. Answering it has pulled the noxious politics around President Barack Obama's signature health care law into the immigration debate.

That's threatening fragile alliances between Republicans and Democrats, already causing one key House member, GOP Rep. Raul Labrador of Idaho, to ditch a House bipartisan group that has been struggling to finalize a comprehensive immigration bill.

"What may be the story at the end of this session is that Obamacare killed immigration reform," Labrador said before a last-gasp effort failed this week to resolve the health care dispute in a way he could accept.

Now the seven other members of the House group are moving forward without Labrador, who said their proposal doesn't go far enough to ensure immigrants must pay for all their own health care costs without leaving taxpayers on the hook for any of it.

Health care and immigrants was a hot-button issue even before Rep. Joe Wilson (R-S.C.) yelled "You lie!" at Obama four years ago as the president told Congress that immigrants who are here illegally wouldn't be covered under his health plan.

For Republicans, allowing immigrants who have been living here illegally to get coverage under Obama's new health law remains a nonstarter, even once they've taken the first steps toward legalizing their status.

"We cannot be providing . . . subsidies to people who have been violating our immigration laws," said Sen. Marco Rubio (R-Fla.), an author of a bipartisan immigration bill that the full Senate began debating yesterday.

The Senate bill bars immigrants in a new provisional legal status, the first step toward a green card and citizenship, from getting taxpayer-subsidized care. That includes Medicaid and tax subsidies to buy coverage in the new state purchasing exchanges being set up under Obama's health law. The immigrants would be in provisional status for 10 years, and only once they get a permanent resident green card would they be able to access health care subsidies.

The approach is opposed by advocates who pushed for provisional legal immigrants to be allowed subsidized care, arguing that it makes sense for public health and the economy.

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