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Press Release Published: Jul 18, 2023

Hearing Wrap Up: CMS Fails to Provide Rationale for Attempting to Rewrite the Law by Expanding Medicaid to DACA Recipients

WASHINGTON—Subcommittee on Health Care and Financial Services today held a hearing titled “Why Expanding Medicaid to DACA Recipients Will Exacerbate the Border Crisis” to examine how the Biden Administration’s Centers for Medicare and Medicaid. Services’ (CMS) proposed rule to expand taxpayer funded federal health benefits to illegal immigrants benefiting from the Deferred Action for Childhood Arrivals (DACA) program is going to lead to higher healthcare costs and fewer benefits for millions of Americans. At the hearing, subcommittee members asked Dr. Ellen Montz, Deputy Administrator and Director for the Center of Consumer Information and Insurance Oversight at CMS, questions to bring transparency to these rules and understand how they could worsen the crisis at our border.

Key Takeaways:

  • The Biden Administration and CMS are willfully incentivizing further illegal immigration by proposing to expand Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) marketplace eligibility to DACA recipients.
    • Under President Biden, illegal border crossings have reached record highs. In fiscal year 2022, U.S. Customs and Border Protection (CBP) reported 2.76 million illegal border crossings, which surpassed the previous annual record by more than one million.
    • The Biden Administration’s disastrous policies along the southern border have already created the worst border crisis in American history.Providing amnesty of enhanced federal benefits to illegal aliens only works to incentivize more illegal immigration.
  • The Department of Health and Human Services (HHS) and the Biden Administration are attempting to alter the definition of who is “lawfully present” yet has not offered a sufficient justification for its reversal of prior rules.
    • In October 2022, the 5th U.S. Circuit Court of Appeals determined the DACA program is unlawful but allowed the program to remain in place for current recipients.
  • The CMS proposed rule will increase the cost of healthcare in federal programs and may make access to care more difficult.
    • A study from the Federal for American Immigration Reform (FAIR) estimates that illegal immigration costs each American taxpayer $1,156 per year. The proposed rule adding roughly 129,000 DACA recipients federal will increase costs by more than $100 million in Medicaid alone and potentially limit access to care for many Americans.

Member Highlights:

Dr. Montz with CMS could not answer Rep. Glenn Grothman’s (R-Wis.) questions as to whether the proposed rule will incentivize more crossings at the border.

Rep. Grothman: “Will this encourage people in the future to come across the border or bring their children across the border?”

Dr. Montz: “I can only speak to what is current law and this proposed rule extends health care coverage to DACA recipients and not other individuals.”

Rep. Grothman: “What do you think is the annual cost of this program?”

Dr. Montz: “Our proposed rule has estimates included in the regulatory impact analysis. We estimate that about 129,000 individuals will gain coverage if this rule is finalized. That’s about 13,000 individuals in the 35 states that have chosen the optional coverage in Medicaid and CHIP and just over 110,000 in marketplace coverage. […] For marketplace coverage, we estimate that to be about 300 million [dollars] per year.”

Rep. Burlison (R-Mo.) pointed out how the proposed rule is contrary to what President Obama’s own CMS stated in 2012 when it concluded that DACA recipients were not eligible for Medicaid benefits.

Rep. Burlison: “When DACA was created under Obama, he explicitly excluded DACA recipients from Medicaid, CHIP, and ACA benefits. Why did he do that?”

Dr. Montz: “I believe the rule referenced is DHS memorandum and policymaking.”

Rep. Burlison: “I don’t know if that was an answer. You said that they issued a memorandum.”

Rep. Virginia Foxx (R-N.C.) emphasized that CMS has failed to offer a justification for its attempt to alter the definition of who is lawfully present.

Rep. Foxx: “So it is the Department of Homeland Security’s considered opinion that they can change the definition of who is legal and who is illegal in this country? Is that what you’re saying?”

Dr. Montz: “I couldn’t speak for the Department of Homeland Security. What I can say is that under this proposed rule, HHS is using its authority under the Affordable Care Act and CHIPRA 2009.”

Rep. Foxx: “Just like the Administration thought it had the authority to pay off student loans under a law passed in 2011.”

Subcommittee Chairwoman Lisa McClain (R-Mich.) examined how despite the substantial constitutional and legal issues surrounding the DACA program, CMS has decided to abruptly reverse course and conclude that DACA recipients should be permitted to participate in Medicaid, CHIP, and ACA programs at the expense of the American taxpayer.

Chair McClain: “Dr. Montz, are you aware that in 2022, the fifth U.S. court of Appeals affirmed that DACA was unlawful?”

Dr. Montz: “I’m aware that there is an injunction for any new DACA recipients.”

Chair McClain: “Did CMS at all consider how external benefits to DACA recipients would spur future waves of illegal immigration? Did that come into your status at all or your decision at all?”

Rep. Montz: “DACA recipients have been here since 2007, so we did not believe that there is any impact.”

Chair McClain: “Can you please identify the section of U.S. code that provides CMS with the authority to set U.S. immigration policy?”

Dr. Montz: “HHS does not set immigration policy; however, we have the authority to set the definition of lawful presence as it relates to HHS’s programs.”

CLICK HERE to watch the hearing.

READ MORE: McClain Opens Hearing on Expanding Healthcare Benefits to DACA Recipients