Posted: 12:12 am EDT
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Following the 2013 report that Russian diplomats were charged with alleged widespread Medicaid fraud between 2004 to 2013 at an approximate cost of $1,500,000 in fraudulently received benefits (see 49 Russian Diplomats/Spouses Charged With Picking Uncle Sam’s Pocket in Medicaid Scam), Congress investigated (Congress Seeks Information on Obamacare Coverage of Foreign Diplomats).
On March 17, the House Committee on Foreign Affairs announced that U.S. Rep. Ed Royce (R-CA), Chairman of the House Foreign Affairs Committee, and U.S. Rep. Paul Ryan (R-WI), Chairman of the House Ways and Means Committee, introduced H.R. 1368, the No Healthcare Subsidies for Foreign Diplomats Act of 2015, legislation to prevent foreign diplomats from receiving subsidized health coverage under the Affordable Care Act (ACA). According to the Department of Health and Human Services, foreign diplomats and United Nations employees in the United States are currently eligible to obtain American taxpayer-funded subsidies under the ACA, such as premium tax credits and cost-sharing reductions, just like American citizens and lawful permanent residents. By contrast, U.S. diplomats overseas do not depend on foreign taxpayers for health care coverage, relying instead on domestic health insurance plans that provide overseas coverage.
Chairman Royce said: “After a year-long investigation, the Obama Administration finally came clean about the fact that foreign diplomats are eligible for taxpayer-funded health care subsidies. This is unacceptable. Americans’ tax dollars should not be used to foot the bill for foreign diplomats’ health care coverage. I am pleased to reintroduce this legislation and look forward to working with Chairman Ryan to pass this commonsense reform.”
- Expresses the sense of Congress that foreign diplomats should be allowed to purchase health insurance coverage in the U.S., but the cost of that coverage should be borne by their sending States;
- Expresses the sense of Congress that U.S. taxpayers should not subsidize the health insurance expenses of foreign diplomats;
- Amends the Internal Revenue Code to make foreign diplomats ineligible for health insurance premium tax credits and cost-sharing reductions under the ACA;
- Requires the Secretary of HHS to certify to Congress that no foreign diplomats are receiving such benefits under the ACA; and
- Requires the Secretary of State to notify all foreign missions in the U.S. that their personnel are ineligible for these benefits under the ACA.
The Committee says that initially, it sent a letter to Secretary Kerry requesting information on the arrest and the eligibility of foreign diplomats receiving government-funded medical benefits. In January and April of 2014, the Committee also sent letters to the Secretary of Health and Human Services regarding foreign diplomats’ eligibility to receive Obamacare. In a response on September 30, 2014, HHS confirmed foreign diplomats’ eligibility for government subsidized healthcare. In October of 2014, Chairman Royce and former Chairman Camp wrote to IRS Commissioner John Koskinen seeking information about how many foreign diplomats have enrolled in the Affordable Care Act and have received subsidies.
The HHS response to the eligibility of foreign diplomats under Obamacare notes the following:
[F]oreign diplomats’ eligibility to participate in the Health Insurance Marketplaces is governed by the Affordable Care Act, which speciﬁes that, in order to enroll in a qualiﬁed health plan (QHP) through the Marketplace, an individual must: (I) reside in the state that established the Marketplace; (2) not be incarcerated, other than pending the disposition of charges; and (3) be a United States’ citizen or national, or a non-citizen who is lawfully present and reasonably expected to remain so for the entire period for which enrollment is sought. Non-immigrant, non-citizens in the “A” and “G” visa classiﬁcations are lawfully present for this purpose, if they have not violated the terms of the status under which they were admitted or to which they have changed after admission. Accordingly, to the extent that a foreign diplomat who is a non-immigrant under an “A” or “G” visa classiﬁcation and who has not violated the terms of the status under which he or she was admitted or to which he or she has changed after admission resides in the state that established the Marketplace and is not incarcerated other than pending the disposition of charges, he or she would be eligible for enrollment in a QHP through the Marketplace. The Department does not collect data on the number of foreign diplomats who participate in the Marketplace.
- Congress Seeks Information on Obamacare Coverage of Foreign Diplomats
- 49 Russian Diplomats/Spouses Charged With Picking Uncle Sam’s Pocket in Medicaid Scam
US diplomats and diplomatic staff in the UK are fully covered, at no cost, by the NHS. I presume this is also the case for diplomatic staff of all other countries.
I think congress could use its time more wisely going after those who use the system and are not legally in the US.
Setting aside the ubiquity of universal price-controlled, low-cost/no-cost health care in many other countries, I am forced to observe that, once more, ignoble chauvinistic elements in our congress are poised to reinforce our already established international reputation for meaningless petty concern over the inconsequential costs of the generally accepted international practice of reciprocal social services for diplomatic personnel and dependents who are and have always been purported to be extraterritorial when serving on mutually agreed assignment in another country.
The absurd bureaucratic complexity of payment for emergency health care in America is generally foregone in many other countries. My family and I were routinely and gently refused, in every country in which we served, when we made good faith offers to pay for such emergency medical services. The cities in which our health needs were met, at very low cost to us or the USG, included Zagreb, Belgrade, Prague, Dar Ed Salaam, Port Louis, Paris, and Waterloo/Brussels. This was less readily true in the case of overseas US military hospitals where all three of our children were born, but equivalent, entirely welcome and satisfactory arrangements were ultimately made, with embassy assistance.
I will always remember fondly the tolerant smile of a hospital administrator In Paris, on an occasion when they treated me for a badly twisted ankle, as she waived me out the door with a soft walking cast and a set of crutches, at no cost. She said no system existed through which they could reasonably accept and process money for their services to me, but if I returned the crutches later, it would be appreciated. The general attitude, in such other countries, was sympathetic disdain for the way that Americans administer payment for emergency medical services. In Belgium, my teenaged son was even served (excellent) beer with his lunch while he was briefly hospitalized with a broken wrist. We paid nothing for his ride in an ambulance, for setting his fracture, or for his cast, going on or coming off. He was rather pleased to be on that particular economy.
I am of course understating the immense value of the routine in-house and med-evac American embassy and consulate medical clinic services which were uniquely available to us, but these were often significantly reinforced by either local international diplomatic or emergency walk-in clinics. There were times when we knew our medical standards would perhaps not be entirely met locally, but no one ever quibbled with us over a bill.