Federal health officials vowed this week to crack down on illegal immigrants who get Medicare — signaling that one part of the Obama administration believes it has authority to deny taxpayer-funded benefits going to those in the country without authorization.
The Centers for Medicare and Medicaid Services said it could save nearly $70 million from 2015 to 2019 by preventing illegal immigrants from taking advantage of Medicare’s prescription drug program or enrolling in Medicare Advantage plans.
“We are proposing to establish U.S. citizenship and lawful presence as an eligibility requirement for enrollment in [Medicare Advantage] and Part D plans,” said a proposed rule posted late Monday.
Sen. Tom Coburn, Congress‘ top waste-watcher, said the agency is making the right move.
“From here, CMS must show they can implement their plans with successful results,” the Oklahoma Republican said. “They also should take the necessary steps to prevent paying taxpayer dollars to dead doctors, doctors with felonies, or dead patients.”
The move raises new questions about the federal government’s eagerness to withhold benefits from illegal immigrants.
President Obama and congressional Democrats agreed not to extend Obamacare benefits to illegal immigrants, but the Internal Revenue Service has repeatedly resisted calls to stop paying a refundable child tax credit to parents who are in the country illegally.
CMS tucked its proposal into Medicare regulations that will be formally published Friday. The proposal also cracks down on doctors and providers who prescribe unnecessary medications or issue fraudulent prescriptions to bilk Medicare.
Illegal immigrants generally are prohibited from receiving federal benefits under the 1996 welfare reform law.
But an internal Health and Human Services audit last year found that while CMS has policies to prevent illegal immigrants from getting most Medicare benefits, it didn’t prevent them from taking part in the prescription drug benefit, or Medicare Part D, which was added under President George W. Bush and expanded by Mr. Obama’s health care law.
The Medicare agency from 2009 to 2011 paid out nearly $30 million in drug benefits to illegal immigrants, the HHS inspector general said in October. In one of its reports, the inspector general said 4,139 illegal immigrants were able to make 279,056 drug benefit claims.
CMS officials acknowledged the problem at the time and said they would take steps to fix it, although some question whether the agency has the tools to find people who are benefiting unlawfully, given that thousands were able to get through the system in prior years.
“They’ve got a long way to go to do what they plan to do,” said David North, a fellow at the Center for Immigration Studies.
Whether or not illegal immigrants should reap taxpayer-funded benefits is an issue that resonates across the federal government. In 2011, the internal auditor at the IRS found that the agency paid $4.2 billion in tax credits the previous year to people who were not authorized to work in the United States.
“The payment of federal funds through this tax benefit appears to provide an additional incentive for aliens to enter, reside, and work in the United States without authorization, which contradicts federal law and policy to remove such incentives,” said the report from the Treasury inspector general for tax administration.