Monday, March 12, 2007

states’ rights

The NY Times has a couple of stories today about clashes between states and the federal government over immigration enforcement. First is this:

A new federal rule intended to keep illegal immigrants from receiving Medicaid has instead shut out tens of thousands of United States citizens who have had difficulty complying with requirements to show birth certificates and other documents proving their citizenship, state officials say.

Florida, Iowa, Kansas, Louisiana, New Mexico, Ohio and Virginia have all reported declines in enrollment and traced them to the new federal requirement, which comes just as state officials around the country are striving to expand coverage through Medicaid and other means.

Under a 2006 federal law, the Deficit Reduction Act, most people who say they are United States citizens and want Medicaid must provide “satisfactory documentary evidence of citizenship,” which could include a passport or the combination of a birth certificate and a driver’s license.

. . .

“Congress wanted to crack down on illegal immigrants who got Medicaid benefits by pretending to be U.S. citizens,” Mr. Jones said. “But the law is hurting U.S. citizens, throwing up roadblocks to people who need care, at a time when we in Wisconsin are trying to increase access to health care.”

There are a lot of elderly and sick New Yorkers languishing in nursing homes, care facilities, hospitals, and on the street who may have lawful status in this country but don’t have the documentation to receive the care they need, or to do things like get a job or open a bank account. Let’s say a naturalized citizen falls on hard times, loses his home and job, doesn’t have much family in this country, and ends up on the street for a time, losing in the process every shred of paper that ever once identified him as a member of the human race. It happens more often than you might expect. Let’s say he wants to start things over and try to pick up the pieces of his life. It can be nearly impossible for such a person to navigate on his own the bureaucratic maze needed to recover the documentary foundation upon which modern life is built.

At the employment office: “You need two forms of picture ID and proof of citizenship to start work.”

At the DMV: “You can’t get a state-issued ID unless you have proof of birth that we accept: birth certificate, passport, non-expired permanent resident card.”

At the Department of Health: “You can’t get a birth certificate without a government-issued ID.” Doesn’t matter in our case anyway, since our guy was born abroad. That’s even worse—just try getting a birth certificate from another country with no valid form of identification.

At Citizenship and Immigration Services: “No more walk-ins today. Use the kiosk in the hall to make an InfoPass appointment.” Our guy soon discovers that an InfoPass appointment requires a government-issued ID.
“But that’s what I need to talk to somebody about.”
“Call our 1-800 number.”
After 45 minutes on hold, our guy is transferred and then told to make an InfoPass appointment.

Can’t work, can’t eat, can’t pay rent. But can’t receive public benefits either, since he can’t prove he exists to the satisfaction of any of the government agencies tasked with keeping track of him. He may as well not exist.

So maybe he gives up and stays on the street. Maybe he dies.

Or maybe he finds a non-profit agency that knows how to request written confirmation of his immigration status from USCIS, then can assist him in applying for a replacement citizenship document and is willing to pay the hundreds of dollars in fees that the government charges for this service. Then with patience and perseverance, he can use that document to get others, and rebuild a life.

But knowing that our sympathies run young, the Times aims to push the right buttons by focusing on another demographic:

Medicaid officials across the country report that some pregnant women are going without prenatal care and some parents are postponing checkups for their children while they hunt down birth certificates and other documents.

Rhiannon M. Noth, 28, of Cincinnati applied for Medicaid in early December. When her 3-year-old son, Landen, had heart surgery on Feb. 22, she said, “he did not have any insurance” because she had been unable to obtain the necessary documents. For the same reason, she said, she paid out of pocket for his medications, and eye surgery was delayed for her 2-year-old daughter, Adrianna.

The children eventually got Medicaid, but the process took 78 days, rather than the 30 specified in Ohio Medicaid rules.

Dr. Martin C. Michaels, a pediatrician in Dalton, Ga., who has been monitoring effects of the federal rule, said: “Georgia now has 100,000 newly uninsured U.S. citizen children of low-income families. Many of these children have missed immunizations and preventive health visits. And they have been admitted to hospitals and intensive care units for conditions that normally would have been treated in a doctor’s office.”

Dr. Michaels, who is president of the Georgia chapter of the American Academy of Pediatrics, said that some children with asthma had lost their Medicaid coverage and could not afford the medications they had been taking daily to prevent wheezing. “Some of these children had asthma attacks and had to be admitted to hospitals,” he said.

In Kansas, R. Andrew Allison, the state Medicaid director, said: “The federal requirement has had a tremendous impact. Many kids have lost coverage or have not been able to obtain coverage.” Since the new rule took effect in July, enrollment in Kansas has declined by 20,000 people, to 245,000, and three-fourths of the people dropped from the rolls were children.

Well, those people probably don’t vote, anyway. A few months with no dialysis should show them the pain of civic disengagement. Serves ‘em right.

So goes the thinking.

Next we have a dust-up between the Massachusetts state government and the feds, who recently whisked away hundreds of immigrant workers across the Mason-Dixon line to prison in Texas via a sort of perverse Underground Railroad:

The head of Massachusetts' social services on Monday called for the release of about 20 factory workers arrested in an immigration raid, saying many have children with no one else to care for them.

They were among the 361 people taken into custody following the raid March 6 at a Michael Bianco Inc. factory that makes equipment and apparel for the U.S. military.

Many of the suspected illegal immigrants were shipped to detention centers in Texas before a federal judge ordered the rest to remain in Massachusetts because advocates said the raid created a ''humanitarian crisis.''

Commissioner Harry Spence was among three-dozen state Department of Social Services workers who traveled to Texas during the weekend to interview more than 200 detainees.

The department workers returned to Massachusetts on Monday after recommending the return of 21 detainees the day before, Spence said. Immigration officials in Texas were releasing nine of those 21, Russ Knocke, spokesman for the Department of Homeland Security in Washington, D.C., said Monday.

. . .

Spence said the detainees he wants released have children ages 2 to 16, and a few of the children had medical conditions that required special care, including one child that required a feeding tube. All were believed to be born in the United States and therefore are U.S. citizens.

. . .

In the days following the raid in New Bedford, a 7-month-old child was hospitalized for dehydration because the breast-feeding infant refused to drink formula and the mother was in custody for two nights. Another mother was located in Texas after her 7-year-old child called a hot line state officials created to reunite families.

Commissioner Spence now seems satisfied that the most pressing concerns were met. But it’s only a matter of time before some baby dies alone at home because her mother is locked up somewhere for a few days without warning. Maybe it’s happened already. We could say, to heighten the outrage, that this dying infant will be a U.S. citizen, but it’s kind of sad if that’s the principal reason people would care.

But this and the previous article highlight the growing tension between the states and the federal government over how and to whom government services are to be provided. What is the purpose of government? Massachusetts views its immigrant workers as constituents and acts accordingly. The federal government views them as criminals and acts accordingly.

Will the free states band together and make a stand against tyranny? Will the federal government crack down brutally in order to preserve the Union?

Well, I doubt that even the free states care enough about their illegal immigrants to incur any grave inconvenience on their behalf. And the current administration is nominally pro-immigrant. Most of the activity at the moment is political posturing ahead of the immigration bill coming down the pike, which may be the most significant immigration legislation in the last decade or two. But it isn’t theatre to the people whose lives and families are being forcibly scattered.

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