WASHINGTON — Latino advocacy groups are ramping up pressure on Congress to expand health coverage for immigrants as the lawmakers grapple with historic health-reform legislation.


Activists and health-policy experts who support greater immigrant coverage are concentrating their efforts on the Senate, which is expected to bar illegal immigrants from participating in health insurance exchanges, as stipulated in the Senate Finance Committee's bill, even if they pay with their own funds and no federal subsidies.


The House voted last weekend to deny federal subsidies to help illegal immigrants buy insurance but allow them to buy health insurance from government-created insurance exchanges.


The Senate Democratic leadership is working to merge two bills before bringing the legislation to the floor for debate.


Senate may be harder sell

However, the major Senate bill — the one written by the Senate Finance Committee — goes further than the House bill and bars illegal immigrants from obtaining health insurance with their own money at insurance exchanges.


"We do not see the same investment (in immigrants) in the Senate, and I think that will be a major component in the outreach by many other Latino organizations," said Jennifer Ng'andu, deputy director of health policy at National Council de La Raza, which lobbies Congress to make insurance accessible to immigrants.


Steven Wallace, associate director of the UCLA Center for Health Policy Research, said he doubts that the final Senate bill would go beyond the House measure.


"My hope is the Senate is a little more enlightened, but my guess is they'll come up with more punitive measures than the House," Wallace said.


Rep. Michael Honda, D-Calif., who pressed the House leadership to ensure that undocumented immigrants could still purchase insurance at full price, argued that including immigrants would help reduce overall health care costs for everyone.


There are an estimated 12 million illegal immigrants in the U.S., according to the Migration Policy Institute, a pro-immigration think tank. They make up 15 percent of the country's total uninsured population, the institute says.


Elena Rios, president of the National Hispanic Medical Association, said Latinos have the highest proportion of uninsured people.


"Diseases know no boundaries," she said. "The best idea would be to have everyone have health care."


Immigration, health care ties

But health-policy experts say that regardless of cost analyses, covering illegal immigrants will remain a political problem for lawmakers who want to look tough on immigration.


Lawmakers' hypersensitivity to immigration makes health care reform "more complicated and less effective," Wallace said.


Health insurance coverage for illegal immigrants has been a debate for a long time, but it attracted national attention in September when Rep. Joe Wilson, R-S.C., shouted "You lie!" after President Barack Obama — speaking to a joint session of Congress — promised that health care reforms "would not apply to those who are here illegally."


The Wilson outburst "illustrated how this issue has moved to the forefront," said Dan Stein, president of the Federation for American Immigration Reform, which supports immigration limitations. "Public mood for lavish public spending for people who have no right to be in the country has ended."