AMNESTY, THEN AID? Lawmakers Divided Over Benefits for Immigrants

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As the Senate prepares to take up comprehensive immigration legislation, one of the most pressing questions is how and when illegal immigrants who set out on the path to citizenship qualify for federal benefits. 

Lawmakers disagree sharply on this front, which could drive debate as they begin formal work on the bill Thursday. 

Sen. Marco Rubio, R-Fla., points out that the proposal says applicants would not qualify for at least 10-13 years -- and would not qualify for another five years after getting a green card, under current law. 

Further, Rubio argues that the proposal has "very specific" rules governing anyone who could be considered a "public charge," or someone who would live off the government dole. 

"If you are a public charge, you don't even qualify for renewal of that temporary status that you're getting," Rubio said. 

But Sen. Jeff Sessions, R-Ala., another Republican senator who has emerged as one of the chief critics of the bill, says the law does not properly enforce that provision. 

Sessions told Fox News that the so-called "public charge" law, as currently written, has been "totally ignored" to date. And he argued that many immigrants will be eligible for benefits much sooner than proponents claim -- including the so-called "dreamers," young illegal immigrants brought to the U.S. their parents. 

Sessions said 2-3 million illegal immigrants who claim that status will be able to have access to federal benefits in five years. 

And, he added, eventually "everyone who entered illegally will be able to accept any benefits this country offers." 

After the 15-year waiting period, the number accessing federal benefits could be an additional 10 or 11 million. 

Nevertheless, Rubio insists there will be checks at every stage of the process. 

"When you re-apply at the six-year mark, by the way you're not eligible for any public benefits at that point, you have to prove you're not a public charge," he said. 

A controversial report released earlier this week by the conservative Heritage Foundation estimated that, under the bill, the total cost of legalizing 11 million illegal immigrants could approach $6.3 trillion over the course of their lifetimes. The study factored in taxes those immigrants would pay, but also the services and other benefits that would be spent on them. 

It has come under heavy scrutiny from some conservative economists who say it ignored significant factors - like the possibility of some of these illegal immigrants moving up the income ladder after coming out of the shadows, while expanding the economy and boosting federal tax revenue.
Sessions and other critics are unconvinced. 

"We respect people who want to come to America. We believe that we should accept immigrants," Sessions said. "But we've got to be realistic about the impact." 

As the debate wages on, Sen. Ted Cruz, R-Texas, on Wednesday offered an amendment to end the dispute -- by proposing to let illegal immigrants stay but deny them from ever receiving any "means-tested benefits," or welfare.

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Dr. Manny: Marriage equality has health benefits for all

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As a practicing physician for the past 30 years, I know one fact to be true: Marriage benefits the family.

I have worked in very busy medical centers, and I have seen numerous patients take on debilitating health problems by themselves.  Many times, their isolation makes things much more difficult.  

To have a support system through marriage means the world when you’re sick.  It means you have someone to listen to your problems, to offer advice; and ultimately, to be your health advocate.

If we look at some of the health benefits of marriage, we find that married individuals recover better after surgery, are less likely to have heart attacks, and are more likely to live longer and be healthier overall.  Also, a study published in the American Journal of Public Health found that married gay and lesbian couples are much more likely to have better mental health than their unwed counterparts.

And marriage isn’t only valuable for the individuals involved, as its health benefits extend to the rest of the family.  Recently, the American Academy of Pediatrics said children thrive when they have two married parents who love them and can provide them with a nurturing environment, irrespective of the parents’ sexual orientation.

In my personal specialty, I see the power of marriage in bringing new life into this world.  I have delivered babies for heterosexual couples, as well as babies for many lesbian couples.  Regardless of a couple’s sexual orientation, the beauty of a newborn child is equally astounding to everyone.

So my message to the Supreme Court, as they deliberate on how to move forward on Proposition 8, is that marriage equality could be quite healthy for our society.  Isolation and inequality are detrimental to our health, ultimately bringing about depression, sadness and anxiety.

I know nobody listens to a practicing doctor like myself anymore, especially since we live in a lawyer’s world, but the facts are the facts.  Marriage is healthy for everyone, especially for our children. It is time we make the world a more equal and joyful place.

Dr. Manny Alvarez

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Survey finds most large employers will keep health insurance benefits after Affordable Care Act

Most large employers don't expect to send their full-time employees to government health exchanges for insurance during the next five years, but some retirees and part-time workers will end up there, a new survey has found.

The outlook for corporate insurance in the long term is less certain.

Only about 26 percent of large employers surveyed were very confident their company will offer healthcare benefits in 10 years. That is a slight increase from last year's 23 percent, but a sharp drop from 73 percent five years ago.

About one-half of the people in the United States who have health insurance receive it from their employers. Most of the rest are enrolled in individual plans or government Medicare and Medicaid programs.

More people are expected to buy health insurance at government-run electronic marketplaces, which will start selling plans for 2014 later this year as part of the 2010 U.S. Affordable Care Act.

Related: ObamaCare Gold Rush: Winners and losers

Consultancy Towers Watson and the National Business Group on Health conducted the annual survey of more than 500 of the nation's largest employers, who self insure, or pay for employee healthcare treatments. The companies were surveyed between November and January, a time when 2013 health plans went into effect and as companies plan for 2014.

During the next five years, 60 percent of large employers said it was not at all likely they would discontinue health care plans for full-time employees and send them to the government exchanges with a financial subsidy for insurance.

Also, 82 percent said they think it was highly unlikely they would direct full-time employees to exchanges without a subsidy.

The Affordable Care Act has implemented a wide range of new rules. More services must be included in plans. Also, companies will need to offer health care insurance to all employees who work more than 30 hours per week or be forced to pay a tax. Because the tax is less than the cost of health care for them, some companies may pay the tax instead.

"There will definitely be employers who will be looking to move certain segments of their workforce towards the public exchanges and those segments could be early retirees and they could be part-timers working under 30 hours," said Randall Abbott, senior consultant at Towers Watson.

Among companies where 20 percent or more of their workforce are part time, 29 percent said it was highly likely that in the next five years they would end health care benefits for employees working less than 30 hours per week. Sixty-seven percent said it was unlikely.

Costs keep rising 
The survey found the average premium cost for employers and employees combined rose about 6 percent in 2013 from 2012. Employees paid, on average, $2,888 in annual premiums, up about 8.7 percent from 2012.

Related: Rate shock: How ObamaCare is causing a surge in insurance premiums 

Total spending on healthcare in the United States was about $2.7 trillion, and is rising at a rate of about 6 percent a year, although last year it was only about 4 percent.

Companies trying to cut health care spending have turned to wellness initiatives, such as charging smokers surcharges. Also, health plans are discouraging health care overspending by employees by putting more of the costs on them.

For instance, instead of paying a monthly premium and a co-pay for doctor visits, many employees may pay a lower monthly premium and then pay for the doctor visit out of a special tax-free savings account until they reach a higher-than-usual deductible.

These consumer-directed health plans in which employees have a tax-free health spending account made up 30 percent of most large employers' health plan enrollment in 2013, up from 25 percent in 2012, the survey found.

Related: Will your doc become extinct under ObamaCare?

About 53 percent of employers offer the plans now and 67 percent plan to do so in 2014. It will be the only option at 23 percent of employers in 2014.

In addition to cutting spending, employers cite the Affordable Care Act's 2018 excise tax as the motivation for the plans, according to Abbott of Towers Watson. The tax, often called the Cadillac tax, is expected to apply to companies that offer high-priced plans as a way to discourage overspending on health care.

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