Senate Immigration Bill Has $20 Billion Medicaid Mandate

Breitbart News has learned the Senate’s controversial immigration reform bill passed in late June contains a Medicaid mandate similar to a provision found in the Affordable Care Act, known to its critics as Obamacare.

A little-noticed part of the Congressional Budget Office (CBO) score of S. 744 shows that it would in fact impose a $20 billion Medicaid expansion on states. According to the CBO score of the legislation, this provision would occur over a decade-long period after the President signs the bill.

“In assessing the impact of the bill on the federal budget, CBO estimated its effect on federal and state spending for Medicaid. S. 744 would have the result of increasing the number of individuals who would become eligible for either full Medicaid or for more limited emergency benefits,” the CBO writes in the section of its Senate immigration bill score on mandates to states. 

“State spending is estimated to increase by about $20 billion over the 2014-2023 period,” the report continues. “Because states have broad flexibility to alter optional benefits and eligibility to offset such costs, the increased spending would not result from an intergovernmental mandate as defined in UMRA.”

In March 2010, the CBO estimated that the Affordable Care Act would impose a similar Medicaid mandate of the exact same amount, $20 billion, over the first 10 years of its enactment. Since many states are required by their laws to keep balanced budgets, they would have needed to raise taxes or cut from other budget priorities to pay for the requirement. 

However, the U.S. Supreme Court determined in National Federation of Independent Business v. Sebelius in June 2012 that the Medicaid mandate was unconstitutionally coercive to states that could not afford it. Many governors around the country have opted out of the expansion, and more are expected to in the future. As of June 14, a total of 13 states have opted out while 26 have signed on. The majority of the remaining states are moving towards non-participation or will pursue an alternative model.

The House of Representatives is working on several bills of its own to tackle immigration reform. Some of the formative legislation reportedly contains language identical to the Senate bill, but nothing concrete has yet emerged for CBO scoring and comparison to the Senate’s effort.