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SUNDAY, MARCH 13, 2011 PAGE 7E
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thereafter. Republican governors say that’s an entitlement program expansion they simply can’t afford. As states try to close $125 billion in budget shortfalls for the next fiscal year, both Republican and Democratic governors say that any new spending is problematic. Twenty-six GOP governors have joined a lawsuit challenging the health care overhaul, which they deride as “Obamacare,” as an abuse of federal power. A report released recently by Sen. Orrin Hatch, R-Utah, and Rep. Fred Upton, R-Mich., says the health care act’s Medicaid expansion will cost states $118 billion over 12 years. That’s nearly twice the amount — $60 billion — that the Congressional Budget Office has estimated for a 10-year period. The CBO estimates that the law would cut the federal budget deficit by $143 billion from 2010 to 2019 and by $1.3 trillion over the following decade, through a combination of new revenue sources and spending reductions. Which numbers are more credible, the CBO’s or the GOP’s? Democrats and independent researchers challenged the GOP report, saying it didn’t use a standard methodology to estimate each state’s costs. It also failed to account for savings that the Medicaid expansion is likely to produce, such as a reduction in state payments for medical care for the uninsured. Republicans defended the report, saying the estimates were conservative and the methodology sound. The Urban Institute, a think tank, projected that from 2014 to 2019, the law will save states and localities $43 billion to $85 billion on uncom-
pered the efforts of immigration-control proponents to effectively do away with “birthright citizenship” for the offspring of illegal immigrants. On the federal level, two Republican senators, David Vitter of Louisiana and Rand Paul of Kentucky, want to accomplish it by amending the Constitution — allowing automatic citizenship only if a child has at least one parent who already is a citizen, a legal permanent resident or an active-duty soldier. On the state level, Metcalfe, joined by lawmakers from 40 others states, is promoting a package of model legislation under the rubric “National Security Begins At Home.” Among those suggested bills: In lieu of automatic citizenship, states would issue distinctly marked birth certificates for the newborns of illegal immigrants, to distinguish them from U.S. citizens. Pointing out that immigration policy is a federal prerogative, immigrant advocates say that such proposals are beyond the scope of state lawmakers’ authority, not to mention unconstitutional. Metcalfe’s “model (birth certificate) statute claims not to confer any particular benefit or penalty on the basis of the different markings,” said Alison Parker, U.S. program director for Human Rights Watch, an international advocacy group. But “differentiating citizens on the basis of their parents’ immigration status would inevitably result in discriminatory treatment.” Supporters of birthright citizenship — including the American Civil Liberties Union, the Mexican American Legal Defense and Education Fund, Migration Policy Institute and the
be discounted. “I think it would be a mistake to dismiss without significance the estimates of skeptics who think things will be more expensive than CBO estimates,” Aaron said. “Just as it would be a mistake to dismiss the estimates of those who believe the costs will be lower and the savings higher.” Medicaid is the third-largest domestic program, behind Social Security and Medicare. Last year, it accounted for 8 percent of federal spending, compared with 20 percent for Social Security and 15 percent for Medicare. On average, states spend about 16 percent of their general fund budgets on Medicaid. That’s second only to elementary and secondary education, which eats up an average of 45 percent of most state budgets.
Constitutional Accountability Center — have hit back hard, issuing white papers on the 14th Amendment’s intent, organizing pro-immigrant rallies and running radio ads. According to a 2010 Pew Hispanic Center analysis, undocumented immigrants comprise slightly more than 4 percent of adults in the U.S. But because of their youth and high birthrates, they produce an estimated 8 percent of the approximately 4.3 million babies born annually. What is the real anchoring power of “anchor babies?” Advocates contend it is overblown. U.S.-born children cannot “protect their parents from deportation,” the Immigration Policy Center’s analysis stated. “Every year the U.S. deports thousands of parents of U.S. citizens.” Those children can sponsor their parents for permanent residency, but not before age 21. In most cases, if the petition is granted, the parents would still have to leave the U.S. for at least 10 years — the penalty for having been here illegally in the first place. The center’s report concluded: “Undocumented immigrants do not come to the U.S. to give birth as part of a 31-year plan.”
But birthright citizenship does have its benefits. In households with typically low incomes, the infants are immediately eligible for Medicaid and other government benefits — even though their parents are not. In arguing for his legislative agenda, Metcalfe stresses the economic impact. The estimated 140,000 illegal immigrants in Pennsylvania, he said, drain state coffers to the tune of $1.4 billion a year — much of it to cover uncompensated emergency-room services for people “who shouldn’t be on our soil in the first place.” In 2006, Jack Ludmir, chief of obstetrics at Pennsylvania Hospital, founded a pre-natal clinic for immigrant women, Latina Community Health Services. He sees about 50 women a week, who pay on a sliding scale that averages $5, but nothing at all if they can’t afford it. He writes their names in an oldschool notebook. Not all are Latina; he has had patients from Egypt and Pakistan. Ludmir doesn’t ask their immigration status. But based on their lack of Social Security numbers, he estimates that at See AMEND, Page 8E
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pensated medical care for the uninsured, and $20 billion to $40 billion on their mental health services. “If the Democrats ... want to argue that the Medicaid expansion included in Obamacare is not going to put a severe financial burden on states, I’m sure you will find the majority of governors disagree,” said Julia Lawless, a spokeswoman for Hatch. Henry J. Aaron, a senior fellow for economic studies at the Brookings Institution, said the CBO’s cost estimates for the new law were still the gold standard because of the agency’s well-established reputation for skepticism on claims of legislative cost savings. But the seismic changes brought on by the law probably will produce some unintended costs, Aaron said, so the GOP estimates shouldn’t
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Obstetrician Dr. Jack Ludmir, center, performs an ultrasound on a young woman from Nicaragua who is also an undocumented immigrant at Pennsylvania Hospital in Philadelphia.
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