rpjs

To include, inter alia using ACA subsidies and CHIP.

This could be a game-over for a lot of people.

https://www.vox.com/2018/2/8/1699317...-public-charge

crg

That may throw a kink in the government subsidized sanctuary city/corporate greed business model that allows low cost labor to subsist and work in the expensive urban areas.

Pulaski

One can only hope so.

Former Lancastrian

Is this only applicable to those who are in the USA be it on TPS, DACA or obtained a Green Card via the visa lottery system or who else does it apply to?

Now I know the US system is totally different to Canada and the UK but there have been several stories about the rising costs of healthcare and that certain health authorities are being saddled with huge unpaid bills be it through birth tourism or where a plane diverts to a country other than its destination due to a medical emergency and Canada sees sometimes 2 or 3 a day due to the US and Foreign carriers using the Polar Route to fly from the West Coast to Europe or reverse.
Normally insurance companies end up paying providing the traveller had health insurance coverage.
Any long term visitor to Canada under the parent/grandparent visa has to take out private health insurance as most Provincial healthcare plans won't cover any treatment they receive in Canada. Workers/Students are usually covered as well as Refugee claimants. Ineligible Refugee Claimants get limited coverage if going through the removal process.

Rete

At present there is in place for all relative sponsored immigrations the requirement that an I-864 Affidavit of Support be given at the time of the adjustment of status if the immigrant is inside of the US or at the US Consulate/Embassy abroad if the intended immigrate is seeking a CR-1 or LR-1 visa which makes them a legal permanent resident once they enter the US on their approved visa.

The I-864 is a means for the federal government to be reimbursed by the sponsoring USC or LPR for any means tested services they obtain until the I-864 is voided by one of several occurrences, i.e. working 40 social security quarters or becoming a USC or death of the sponsor and finalization of their estate or voluntary or involuntary surrender of the green card.

For those immigrants who came to the US, whether illegal without inspection or legally with an approved tourist visa or use of the VWP, chose to remain in the US illegally to live and work, there is no I-864 in place and the government has no way of seeking reimbursement from a sponsor and can only go after the illegal for reimbursement.

From reading the article it would appear that the proposed bill, if approved, would extend the means tested list to include other services and place a bar on obtaining a green card at some point in the future if the illegal is offered sponsorship by say one of their children who was born in the US and is a USC and at age 21 could petition for adjustment of status for their illegal parent if the parent was inspected at the border/POE when they originally entered the US or if an amnesty is offered by the federal government.

From the brief article, I understand people being upset about limited healthcare for legal and/or illegal immigrants. Good healthcare should be available to all residents of the US regardless of ability to pay. As for Head Start programs, if the child were a child born in the US of an immigrant that child should be able to get healthcare and/or attend a pre-kindergarten class as any other USC can without fear of government interference.

There is one example on these forums of a recent poster who entered the US with a job transfer but with a LR-1 visa due to marriage to a US Citizen. They are working, bringing in money, but their company would not start healthcare benefits for 3 months (which is almost always standard for someone starting new employment) so the LPR signed the family up for state healthcare at no cost. IMPO, I don't see why that should be allowed for the LPR and only should have been allowed for the USC spouse and child. I would go further and say that it should not have been allowed as free healthcare since there was gainful employment but the state government said that since taxes hadn't be filed they consider them to have no means of support.

What all this is going to come down to are arguments of humanity. How can you ... blah, blah, blah. Should be interesting to listen to the various arguments nationwide, not only while the bill pending, but if it were to be made law.

jenn32

Exactly. On the one side is the argument that the citizens of the United States do not OWE "good healthcare" to anyone and everyone who happens to in the US either legally or illegally who is not a USC or green card holder at the time a medical need for that person arises. Healthcare is not an unlimited commodity and it is expensive. In the UK and Canada, a visitor does not have the right to access the NHS or the provincial health systems simply by happening to be in the country - not to say that care would be denied in an emergency to someone without travel health insurance or the means to pay, but it would be an exception, not an entitlement.

On the other hand is the appeal to emotions - "How can you deny needed healthcare just because the person is not a USC or a legal permanent resident or has no insurance or the means to pay? That's inhumane, that's not who we are." That emotional response and the entitlement mentality behind it is likely to eventually bankrupt the country.

steveq

That's very true and well said, but medical staff in the UK are REFUSING to ask for evidence of citizenship to people presenting themselves for free medical services.

tom169

I dare say any of us American residents could get no questions asked medical treatment in the UK with anything mildly representing a British accent.

zzrmark

A USC friend of ours broke her elbow whilst vacationing in Scotland last summer, she was most surprised that there was no bill. I very much doubt that she or her hubby could even pull off a plausible Dick van Dyke 'British' accent.

yellowroom

I dare say the medical staff have enough to do treating the patients without demanding the evidence of UK residence.

I believe the requirement for proof of residence varies from Trust to Trust and even hospital to hospital. I gather in the big cities and tourist locations, the clerical processes are in place to deal with, and recover, costs incurred from foreign visitors, because the number of people involved make it worthwhile employing people to do so. Whereas if you rock up at a location that does not deal with non-UK residents very often, and you have a relatively minor injury or illness, the costs involved in having someone taken away from normal duties to chase down the money is more than the cash to be recovered.

rpjs

Visiting the UK a couple of years back, my wife needed to get a prescription filled (due to leaving medication on the plane at LHR...), and so had to have a consultation with an doctor at an NHS walk-in clinic in central London. As she'd been a UK resident previously her records came up on their computer when she gave them her name and birthdate, and even though she was clearly American the were "are you *sure* you're not resident in the UK?". The consultation fee was only forty sovs and the prescription was cheaper as a private prescription than an NHS one, so we didn't mind paying at all, but the staff seemed to be going out of the way to accept her as a resident if she'd so claimed.

Former Lancastrian

In a fair world a person who needs immediate medical treatment for a potential life threatening incident should be treated no questions asked.
Now after the treatment comes the question of who if anyone should pay for this treatment?
Are you a citizen or LPR covered under a plan which costs you nothing sort of like the NHS or Canadian system?
Are you covered by your employer or insurance plan?
What happens if you have none of the above and in fact have no legal status within the country that has treated you?
Who is on the hook for those costs?
As a taxpayer would you be happy if someone skipped out on a $250,000 service provided and the costs cannot be recovered?

Giantaxe

"Treatment in A&E departments and at GP surgeries remains free for all."

https://www.gov.uk/government/public...-hospital-care

Surprised by that statement (document is dated December 2017) as I thought only the former was free of charge for visitors.

This only mentions emergency treatment:

https://www.nhs.uk/NHSEngland/AboutN...e-the-eea.aspx

zzrmark

That might be the bill for patching up a bloody nose and a black eye in the US but a tourist would have to be in pretty poor shape to get 1/4 million bucks of service from the NHS.

steveq

Thing is, is it really less expensive ? What DOES NHS treatment cost the country ?